Sessions & Schedule
MONDAY, December 7, 2020
9:00am - 10:00am
Welcoming Presentation with Chuck Ingoglia, President & CEO, National Council on Behavioral Health and Lori Shibinette, Commissioner, NH DHHS
10:00am - 10:30am - Break
10:30am - 11:30am - Session A Breakouts
A1 Impact of COVID-19 on People who Use Substances in NH: Findings & Actions to Address
This workshop will present findings of recent surveys by Dartmouth researchers on the Impact of Covid-19 on substance use and mental health in NH and will explore ways that first responders, community outreach workers, healthcare staff and others can better align and integrate their work to help mitigate Covid-19 related harms in people challenged with substance and/or mental health issues during this time. This workshop will explain major impacts of Covid-19 on substance use and mental health in NH as well as identify actions to reduce harm associated with Covid-19 impact on substance use and mental health. Presenters will also articulate strategies to increase collaboration between community outreach, healthcare, first responder and other relevant systems to reduce substance and mental health related harm in the time of Covid-19. Seddon Savage, MD, MS; Jeffrey M. Stewart, NRP, CAI, CRSW; Molly Rossignol, DO FAAFP FASAM & Lauren Chambers
A2 Continuity of Care through Strengthened Interagency Collaboration
This presentation will help participants create, support, and coordinate team-based health care, integrating continuity of care efforts for mental, physical, and behavioral health needs. At the completion of this program, the participants will have an overview of how to create and maintain a model that can be replicated by other mental health centers and developmental services agencies to improve continuity of care for those with co-occurring IDD and mental health needs, creating an expectation of partnership, rather than an exception. Participants will also have the tools to identify and understand various roles of team members, supporting a pathway for continuity of care and person-centered outcomes, as well as tools to identify transferable professional skills and approaches to care, allowing for consistent implementation clinical interventions in all settings. Julie Lago, LICSW & Jennifer Chisholm, MEd.
A3 Advances in NH’s System of Care for Children, Youth, and Families: Recent Evidence, Practice and Policy Considerations
This workshop will present evidence as well as practice and policy implications associated with recent advances in NH’s System of Care (SoC) for Children and Youth with serious behavioral health needs and their families. First, a timeline of the recent advances and victories in establishing NH’s Children’s SoC will be presented. Second, evidence of effectiveness, predictors of outcomes, and cost implications from evaluation of multiple wraparound care coordination programs – collectively involving hundreds of youth and family members – will be summarized. Third, break-out rooms will be used to facilitate small-group consideration and discussion of the practice, policy, and data-related implications of the findings. This workshop seeks to increase awareness of recent advances in the NH Children’s System of Care; disseminate evidence on the process, outcomes, and cost-implications of NH Wraparound, a core element of NH’s SoC; and promote consideration and cross-fertilization about practice, policy, and data-related next steps. Jim Fauth, PhD.
11:30am - 1:00pm - Lunch and “Meet & Greet” with Our Sponsors
1:00pm - 2:00pm - Session B Breakouts
B1 The Benefits of Co-Design with Vulnerable Populations to Enhance Engagement
This interactive presentation focuses on the value of utilizing co-design and implementation considerations for collaborating with vulnerable populations especially during the remote access realities of a pandemic. The rationale is for improving client engagement and practical approaches for proactively integrating your clients voices, and using this as the core focus for program development or improvement initiatives based on the Experience- Based Co-Design (EBCD) model. By the end of this workshop participants will understand the benefits, rationale and challenges for experience-based co-design, have gained knowledge of the important steps to integrate in the process in practice and be able to identify opportunities to utilize the concept of co-design in their home clinical setting. Julie Bosak, DrPHc, CNM, MSN
B2 There’s No Place Like Home: A Multidisciplinary Approach to Homelessness In the Wake of Covid-19
This workshop will focus on how the City of Manchester and numerous community partners such as Families in Transition and The Mental Health Center of Greater Manchester (among other partners) recognized, developed and responded to the marked increase in unsheltered homeless in the city. Due to the presence of Covid-19 the City of Manchester and community partners had to reconfigure the ways in which we collaborated around providing services to the unsheltered homeless population in the city. This led to rapidly breaking down barriers in order to literally work side by side in this effort. Through this rapid response to a vulnerable population in the wake of a global pandemic, our partnership developed a comprehensive community response, strengthening our community partnerships and creating positive outcomes for the unsheltered homeless in Manchester, NH. This workshop will provide basic information about unsheltered homelessness in the Manchester, NH area both pre Covid-19 and post Covid-19; information about the enhanced response to unsheltered homelessness in the Manchester, NH area as a result of Covid-19, and information regarding the impact of a widespread community response and the impact across systems such as health care, housing and emergency response. We will discuss outcome measures the city wide response uses to evaluate positive outcomes, the impact on community partnerships with mental health services, emergency responders and housing programs in the Manchester, NH area, and the next steps in a comprehensive community response post Covid-19. Taunya L. Jarzyniecki, LCMHC, MLADC; Matthew Bouchie, BA; Meghan Shea, LICSW, MLADC & Christopher Hickey
B3 Ask, Link, Collaborate: Identifying Military, Veterans and Their Families Leads to more Effective Treatment and Referrals
“Have you or a family member ever served in the military?” This intentionally specific question has been used in New Hampshire to ensure Service members, Veterans and their families get connected to the appropriate courses of treatment, resources and referrals. It has received national attention for its simplicity and effectiveness. New Hampshire is now re-launching the campaign with an enhanced focus to help professionals move beyond the question to the procedural and operational behaviors of Ask, Link, Collaborate. Workshop participants will learn about New Hampshire’s military landscape, why it’s important to identify Service members, Veterans and their families and then how to move beyond Asking the Question and use that knowledge to provide appropriate and effective treatment, resources & referrals. Participants will gain an understanding of the interdisciplinary resources available to those who have served and will leave with tools to facilitate the practice of Ask the Question: Ask, Link, Collaborate. At the end of this workshop participants will be able to demonstrate: knowledge of how to identify if a patient/client is a military Service member or Veteran; understanding of why it’s important to identify individuals who have served in the military and their family members, and an ability to appropriately match Service members, Veterans and their family members to available resources in New Hampshire. Participants will also gain an understanding of how to act as a Veteran advocate by identifying organizational and operational strategies that benefit Service members, Veterans and their families. Amy Cook
2:00pm - 2:30pm - Break
2:30pm - 3:30pm - Session C Breakouts
C1 Advancing the LGBTQ+ Diversity in Your Organization: A Community Mental Health Center’s Journey to Implement Systematic Inclusion and Create a Gender Affirming Environment
In a recent 6-3 ruling, the U.S. Supreme Court made it unlawful for employers to discriminate against LGBTQ+ workers based on their sexual orientation and gender identity. This protects LGBTQ+ people from being denied jobs, promotions, or being terminated because of who they are. With the increase advocacy and awareness of LGBTQ+ issues, many employers are now reviewing their employee policies. While it is now required for employers to promote inclusion, some employers began this work much earlier prior to this ruling. In addition, healthcare agencies in particular must also be mindful of the clients they serve, and hence, the work doesn’t stop with just their employees. It is also ensuring inclusive, respectful, and gender affirming health care service delivery is provided in a heavily regulated environment traditionally overseen by state regulations, insurance company outcomes, and other compliance systems. While the steps to implement may seem daunting for some companies, The Mental Health Center of Greater Manchester describes and shares their organization’s journey and steps taken to do just that . Participants in this workshop will learn and be able to describe: the new inclusion ruling, what the Human Resources process was to create specific revisions made to H.R. policies & practice to promote an inclusive work environment, the various committees and educational trainings that were conducted to ensure inclusive, respectful, and gender affirming health care service delivery and the needed clinical tools developed, and implemented to work with clients and families who are seeking gender affirming care. Participants will also learn how to partner with internal and external community partners to leverage resources and advance goals. Caroline Consoli, Iphigenia Catherine Hatt & Emmett J LeBlanc
C2 The Connect Program: Promoting Healing and Connectedness after a Sudden Death to include Suicide, Before, During, and After COVID-19
This workshop will cover how an effective response to suicide and other sudden deaths demands an approach that recognizes the multiple layers of effects a death by suicide can have. The presenter will discuss how to help strengthen individual and group coping skills after a loss. Evidence-supported protocols for communication after a suicide will be outlined to help support both individual and community healing. Local and national resources that can be of support in the healing process will be identified. Participants will examine the impact of sudden death and suicide contagion on individuals and community and be able to identify national best practices for suicide postvention. Participants will recognize and enhance their coping skills after a sudden death such as suicide and be able to discuss protocols for communication after a suicide to ensure immediate, follow-up response across the community. This workshop will also offer community resources and how to refer others to those resources when needed. Ann Duckless, MA
C3 Setting the Tone
How does a health provider or educator create a safe space for their participants, students, or other stakeholders to be themselves? While large gestures, decorations, and statements can be important, what are some of those smaller steps that can be woven through from day to day, in structured programming and services, as well as during more informal interaction points? Through activities and discussion, participants will explore ways to put our classrooms and organizations forward as safe spaces for individuals of all identities to feel respected and comfortable being their full selves. Participants will learn activities and actions, both as professionals and with our stakeholders, that help them connect with each other and embody the unique combination of all of their identities. This workshop is appropriate for participants with various levels of experience of having put these ideals into action. Participants will be able to identify the breadth of cultural identities that make up the groups we work with in an ever-evolving understanding of cultural identity. Participants will experience activities that can be utilized to quickly and safely create culturally responsive spaces, as well as explore language to engage others in discussions involving intersecting cultures and identities without telling them how to think or feel. Marissa Carlson, CPS & Maura McGowan, CPS
3:30pm - 4:00pm - Break
4:00pm – 5:00pm - Session D Breakouts
D1 Working with Deaf and Hard of Hearing Population in an Integrated Care Setting
This workshop provides an overview of special considerations when working with Deaf and hard of hearing individuals in integrated care settings, including a review of ProHealthNH and Deaf Community Health Work. By the end of this workshop participants will increase knowledge of Deaf Culture and NH Deaf and Hard of Hearing Community; increase understanding of special considerations when working with Deaf and hard of hearing people who will benefit from integrated health care approaches; and increase competence in utilizing communication access strategies with people who are Deaf or hard of hearing. Holly Rioux, LICSW & David ‘DT’ Bruno, MSW
D2 Identifying and Managing Burnout and Compassion Fatigue in Healthcare Professionals
Within this workshop the presenters will share their respective research on the topic of burnout and compassion fatigue from identification to interventions. The session goals are to provide an educational opportunity that encourages workforce stability and improves health and well-being of healthcare professionals by identifying burnout and compassion fatigue as well as inventions that would support the reduction of such conditions. The presenters will also share evidence from each of their respective literature reviews in support of the findings. Jamie Moore, PA & Kerri Swenson
D3 Partnering for Hope: First Episode Psychosis Services in NH
Every year, about 100,000 teenagers and young adults in the United States experience their first psychotic episode. While this can be a scary and isolating experience, there is hope. In this workshop participants will learn about a program that: results in improved symptoms, relationships and quality of life; increases involvement in work or school; and promotes engagement in treatment. Lived experiences and collaborative efforts to increase access to this important program will also be discussed. At the end of this workshop participants will be able to: summarize the key components of Coordinated Specialty Care for First Episode Psychosis (CSC-FEP); identify current efforts and offerings across New Hampshire; reflect on the lived experience of an individual who experienced symptoms of psychosis; and visualize a future where everyone has access to CSC-FEP in NH if needed. Cynthia L Whitaker, PsyD, MLADC; Paul Lassins, LICSW; Theo Baars, CRSW & Michelle Wagner, MS
TUESDAY, December 8, 2020
9:00am – 10:00am - Session E Breakouts
E1 Understanding Brain Injury and Mental Health
This presentation will help participants to understand the impact that brain injury can have on mental health symptoms, as well as aid in dissecting what are behaviors and what are symptoms. The goal of this session is to provide participants with a general overview of common side effects of brain injury. Participants will also be able to better understand and speak to how mental health can be affected by brain injury, have the basic skillset to better identify the difference in symptoms and behaviors; both for brain injury and mental health diagnoses; and gain understanding of how to work with clients directly to meet their needs. Participants will acquire the knowledge necessary to best meet individuals with brain injury where they are at in their recovery period, as well as their stage of change. Chelsea Conner, MSW, CBIS & Samantha Martin, CBIS
E2 Building Knowledge and Confidence: A Quality Improvement Approach to Team-Based MOUD Services
This workshop will share how teams can utilize two quality improvement (QI) tools, Plan-Do-Study-Act (PDSA) and Process Mapping, to improve their processes. Clinical scenarios will be shared, related to the integration of Medications for Opioid Use Disorder MOUD in community health, community mental health, and primary care settings. Participants will be led through a facilitated process on the application of QI tools to clinical scenarios drawn from our experience when working with clinics in the field.
Participants will be invited to break-out rooms to collaborate on the application of each tool to a clinical scenario. The participants will then join the full session where each group will be invited to share their application of these QI tools with other teams with review and commentary by the presenters. This workshop will help increase knowledge of application of QI tools for uptake of Medications for Opioid Use Disorder (MOUD) best practice guidelines and enhance confidence of care teams in using QI tools for improving MOUD delivery systems. Dee Watts; Owen Murray, MA, MS, LMFT & Katherine Cox, MSW
E3 Strategies to Increase Peer Support Specialists’ Capacity to Use Digital Technology in the Era of COVID-19: Pre-Post Study of the Digital Peer Support Certification
This discussion will focus on the internationally recognized Digital Peer Support Certification, in which over 2000 peer support specialists and recovery coaches have been trained in the United States, Australia, Canada, and Europe. The goals of this workshop are to assist participants in understanding digital peer support competencies; develop an understanding of the benefits of digital peer support on people with mental health conditions and/or substance use challenges, explore the benefits of digital peer support on peer support specialists capacity to use technology and knowledge and skill development; and learn how to increase capacity of peer support specialists to provide digital peer support. Karen Fortuna & Amanda Myers
10:30am – 11:00am - Break
11:00am – 12:00pm - Session F Breakouts
F1 Cultivating Community Connections to Prevent Youth Suicide
This workshop will examine the Care Liaison role in three NH public health regions to facilitate pathways to care for youth/young adults at high-risk for suicide. A project currently underway in NH for young people, aged 24 and under, who have been hospitalized for a suicide attempt or are at risk of hospitalization for suicidal ideation will be discusses and described. We will look at the strategies, tools, intervention considerations for restrictions related COVID-19, challenges, and successes in the pilot phase of this five-year project. The goals of this session are to examine the process for safety planning with high-risk youth and young adults during and/or after a hospitalization for suicide risk; describe challenges and opportunities for involving family, community members, and organizations (i.e. schools) in creating a safety net for youth following a psychiatric hospitalization; and examine the value of non-demanding caring contacts as a suicide prevention intervention for high-risk individuals. Kelleen Caravona, CPS, Elaine de Mello & Jennifer Mulryan
F2 Generational Trauma and Substance Use
This workshop expands the Adverse Childhood Experiences Study to include the impacts of historical and generational trauma on persons who are substance involved. The presenter uses her own family history to illustrate how oppression, war, and poverty carry their effects through generations. Attendees will be able to: identify how trauma in previous generations impacts clients’ lives; name how social location and current cultural events influence recovery; and recognize the value of a generational narrative to understand the inter-generational passage of substance use disorders. Linda Douglas, MLADC
F3 Substance Use Disorder Treatment in Emergency Departments and Outpatient Care Settings: Improving the New Hampshire Health Care System’s Ability to Respond to the Opioid Epidemic
The workshop will provide an overview of the substance use disorder treatment project, which has involved 15 hospitals in 22 subprojects in the last four years, to improve the capacity of the New Hampshire health care systemin addressing the opioid epidemic which has claimed thousands of lives in this state. Specific strategies focus on provider credentialing for medication administration, education for health care staff to understand the disease of addiction and its treatment, stigma erasure, and harm reduction. The results of the project will be discussed, including the number of patients treated and retention in treatment programs. Workshop participants will increase their knowledge of the impact of the opioid epidemic on New Hampshire citizens and its economy; inclusive strategies across the continuum of care to provide a comprehensive treatment approach integrating evidence-based medication treatment and social behavioral interventions; and evaluation strategies for assessing project performance. Lindy Sue Keller, MS, MLADC & Daniel L. Andrus
12:00pm – 1:00pm - Break
1:00pm - 2:00pm - Session G Breakouts
G1 Implementing Trauma-Responsive Programming in Emergency Department Settings
The Behavioral Health Clinical Learning Collaborative is a multi-year grant funded program designed to address the management and treatment of patients experiencing mental health crises in the emergency department setting. The Behavioral Health Clinical Learning Collaborative members from 2 hospital emergency departments, in partnership with their community mental health center, participated in pilot projects to train staff on trauma-informed care principles and implement an individualized trauma-responsive strategy within their emergency department. Participants in this workshop will realize the widespread prevalence of trauma in the emergency services population, understand the role of trauma in mental health and emergency services involvement; and identify opportunities for trauma-responsive programming in emergency settings. Nancy Fennell; Ashley Purugganan, MSW & Taunya L. Jarzyniecki, LCMHC, MLADC; & Jennifer Pletcher, MPH, BS, RN, CEN
G2 Best Practices for Integrating Mental Health Services in Schools
This session will explore best practices for the integration of mental and behavioral health supports and services in New Hampshire’s K-12 schools. Following an examination of the recent history of mental health services in NH schools, participants will hear about the lessons learned from Project AWARE, a recent, five-year initiative led by the NH Department of Education and funded by SAMHSA. The session will close by discussing the future direction of school-based mental health services and offering participants the chance to ask questions and share feedback. Goals of this session are to: familiarize participants with the history of mental and behavioral health service integration in NH K-12 schools; review the lessons-learned from past projects focused on school-based mental and behavioral health; and help participants in considering opportunities for effectively initiating integration of services into educational environments. Susan Ward, MA & Megan Phillips, PsyD
G3 Do NH Youth Vape? Clinical and Population Health Interventions to Support Youth ENDS Cessation
According to the 2019 NH Youth Risk Behavior Survey (YRBS), 49.8% of high school-aged youth had ever used a vaping product (an increase from 41.1% in 2017) and 33.8% currently use a vaping product (an increase form 23.8% in 2017); in comparison 5.5% currently smoke cigarettes. In the statewide survey on ENDS use by NH youth conducted by JSI/CHI, the overall prevalence of using a vaping device by ever use was 60% and by current use was 53%. New Hampshire high school-aged youth vaping product use is significantly higher than the US and more than 23% plan to use a vaping product in the future. With funding and direction from NH DHHS, a strategy to research youth and to develop a social marketing campaign to prevent and reduce ENDS use among these youth in NH was developed. A statewide survey was employed to analyze responses for ENDS use, attitudes, beliefs, and intentions by peer crowd. Research informed message creation for an impactful ENDS prevention campaign was then aimed at NH youth age 13-18 entitled “Save Your Breath”. Concurrently, NH DHHS enhanced the State-supported cessation resource, QuitNow-NH to support youth in quitting vaping. The U.S. Public Health Service Clinical Practice Guideline, Treating Tobacco Use and Dependence calls for systems level tobacco intervention efforts using the 5As or Ask, Assist and Refer as evidence based brief intervention for tobacco treatment; much like SBIRT, the system provided for youth is the mechanism for providers to treat every patient identified as using tobacco at every visit – and for youth to find help on their own. Teens can access specially trained Quit Coaches that will help them build a quit plan, identify triggers, practice refusal skills, and obtain ongoing support for changing behaviors in order to be free from nicotine. Workshop attendees will learn how to utilize this service to treat youth and adult patients for nicotine dependence via the web-referral system or embedded EMR. As a result of this session, participants will be able to implement a systems change to treat ENDS use in youth or adults in NH for nicotine dependence; describe the impacts of implementing a population-based prevention campaign to support a system-change objective; and create an implementation plan to screen and refer to treatment for youth nicotine dependence. Christin D’Ovidio, MFA, CCPH; Teresa M. Brown, BS, TTS; Jessica Morton
2:00pm – 2:30pm - Break
2:30pm – 3:30pm - Session H Breakouts
H1 Suicide Screening and Intervention Strategy for New Hampshire Emergency Departments
Following the 2020 Behavioral Health Summit presentation on the need to standardize suicide risk screening in the Emergency Department (ED), members of the Behavioral Health Clinical Learning Collaborative will present on their implementation of the Columbia-Suicide Severity Rating Scale (C-SSRS) screening process in their ED. They will share techniques for leadership and staff buy-in, workflow development, training and interviewing guidelines, risk stratification, and patient experiences and safety, from a clinical and project management perspective. This session will provide recommendations for suicide screening and intervention in the EDs based on current evidence, experience, and input from Collaborative members. By the end of this session, participants will understand how suicide screening tools can assist clinical staff in connecting with the patient and identifying suicidal ideation and risk and recognize the implementation considerations involved designing a suicide screening and intervention strategy in the ED setting. Nancy Fennell; Dennis Walker, MSW & Christopher Dion, BS, MBA, CQA
H2 A Collaborative Effort to Implement and Scale Suicide Prevention Strategies Nationwide
The American Foundation for Suicide Prevention (AFSP) has set a bold goal to reduce the annual suicide rate in the United States 20% by the year 2025. Through system dynamics modeling, and with guidance from leaders in suicide prevention research and practice, AFSP has identified four critical prevention areas that, through strategic investments and partnerships, can be targeted to significantly reduce the suicide rate and potentially save more than 20,000 lives over five years. Within this session participants will be provided with new evidence emerging in the field of suicide research, including innovative solutions to suicide prevention care. Participants will become familiar with key partners and places within the four identified critical prevention areas in which Project 2025 is implementing tools and educational opportunities, such as through the introduction of the ICAR2E tool for managing suicidal patients in the Emergency Department; SafeSide a framework to guide evidence-based care and a unique training model to support Zero Suicide and other quality initiatives; and guidelines for working in particularly at-risk settings such as correctional systems and the firearms owning community. Finally, participants will be encouraged to call for systems change and create compelling cases for why suicide prevention in the four areas must be a priority and suicide prevention strategies. Megan McCarthy
H3 Therapeutic Cannabis: State of State Oversight, Provider Education and Use in Special Populations: Focus on Women of Child Bearing Age
Cannabis is the most common illicit drug used by women. Women across NH report using cannabis in lieu of standard FDA-approved medications, (both prescription and over the counter), aiming to relieve a variety of symptoms including anxiety and depression, insomnia, pain and nausea. While some studies show certain types of cannabis or its components may improve symptoms associated with some medical conditions, it is important to weigh potential benefits against the risks and contraindications for women of childbearing age in particular. Presented by a panel of members of the Therapeutic Cannabis Medical Oversight Board of the NH Therapeutics Cannabis Program, this workshop is designed to provide a foundation of information that is useful for medical care providers and behavioral health care providers who care for women who use cannabis for therapeutic purposes. This presentation will offer culturally appropriate, science-based, practical information to help providers and patients think critically about cannabis use for therapeutic purposes in a clinical setting. We will focus on determining when cannabis may or may not be an appropriate choice for patients, discuss the operations of this, review best practices of making this recommendation and appropriate follow up. The objectives of this workshop are to: review Cannabis use for medical conditions and symptoms; aid participants in recognizing the herb, its constituents, and available products as well as appreciate the truth about benefits of Cannabidiol (CBD); and increase awareness of availability of products and purity. This session will also review clinical management of therapeutic use of Cannabis and review: the NH therapeutic cannabis program; evaluation and monitoring outcomes of patients; review evidence of efficacy for pain, opioid use disorders, anxiety and sleep as well as recognize side effects and potential risks of use; cite special risks during pregnancy and while breastfeeding and raise awareness of vetted patient education resources on Cannabis use during pregnancy and while breastfeeding. Jerry Knirk, MD; Seddon R. Savage MD, MS; Molly Rossignol, DO, FAAFP, FASAM; Virginia C. Brack, MD; & Lisa Withrow, APRN, FNP-C, ACHPN
3:30pm - Session Adjournments