Integrate Substance Use Prevention & Mental Health Services
Improve Detection & Treatment of Mental Health Conditions
Return to Opioid Top-Level Strategy Map or Zoom Map (Minimize Desire to Misuse Opioids)Table of Contents
Background
Initial use of opioids by youth is often done as self-medication for dealing with trauma, depression or anxiety. (Research and sources needed)
In one national survey of young adults aged 18-24, more than 61 percent of respondents who had used opioids not prescribed to them had done so primarily to relieve anxiety and stress[1] .
Youth are Struggling with Mental Health Issues
A nationwide U.S. survey of over 1300 14- to 22-year-olds done in February and March of 2018 shows evidence of a growing mental health crisis affecting young people. The survey, sponsored by Hopelab and Well Being Trust (WBT), finds that many teens and young adults are experiencing moderate to severe symptoms of depression are turning to the internet for help. Common uses of the Internet include researching mental health issues online (90 percent), accessing other people’s health stories through blogs, podcasts, and videos (75 percent), using mobile apps related to well-being (38 percent), and connecting with health providers through digital tools such as texting and video chat (32 percent). [2]
Co-Occurring Disorders
Co-occurring disorders, or dual diagnosis, refers to having a simultaneous mental health disorder and substance use disorder. It is common for people with addictions to also suffer from depression, anxiety, or more severe mental illnesses such as schizophrenia or bipolar disorder. Research shows that people who use alcohol or other drugs early in life are more likely to have mental or emotional problems. It’s also true that many people with mental illnesses “self-medicate” with alcohol or other drugs to numb emotional pain, relieve anxiety, or quiet their thoughts. In the past, the medical profession treated one disorder first, typically the substance use disorder, before addressing the other. It is now understood that treating both simultaneously leads to better outcomes. Any successful addiction treatment program will include a mental health assessment and treat co-occurring disorders at the same time.
Promising Programs
There are a growing number of promising programs for helping to identify and address mental health issues.
M3 Checklist (Screening Tool)
M3 Information developed a mental health screen that measures outcomes based on a 27-question diagnostic checklist and a related algorithm targeted for adults aged 18 and older. The M3 Checklist accurately measures outcomes based on question responses for major depression, bipolar disorder, anxiety disorder and posttraumatic stress disorder (PTSD).
Project Aware
Project AWARE is a SAMHSA program that focuses on student mental health and wellness, While not specifically focused on opioid abuse prevention, much of the work that grantees are doing may also help prevent opioid misuse. Through Project AWARE, schools are implementing evidence-based, culturally appropriate prevention programs that support youth at the universal, selective, and indicated levels.
Communities that Care
Programs such as Communities That Care promote a range of youth mental and behavioral health outcomes, included reduced risk for opioid misuse and addiction. (Find Source)
myStrength
myStrength is a digital platform that integrates state-of-the-art technologies to support people in addressing mental and behavioral health issues. It can be integrated with a professional practice to allow them to see more patients more efficiently and better meet the needs of their patients between in-person visits. Learn more at this recorded Webinar.
Depression
- Because depression is under-diagnosed and untreated, depression and opioid abuse are strongly concurrent.[3]
- People with depression show abnormalities in the body’s release of its own opioid chemicals[4]
- Depression tends to exacerbate pain—it makes chronic pain last longer and hurts the recovery process after surgery[5]
- Depression nearly doubles the risk that someone already using opioids will continue to use them long-term[6]
Depression & Opioids
- Depressed people are about twice as likely as non-depressed people to misuse their painkillers for non-pain symptoms[7]
- Depressed individuals were between two and three times more likely to ramp up their own doses of painkillers [8]
- Adolescents with depression are also more likely to use prescription painkillers for non-medical reasons and to become addicted[9]
- Depressed people are likely to keep using opioids, even when their pain has subsided and when they are more functional [10]
Stigma & Depression
Stigmatization of depression can reduce the likelihood of people reaching out to get the mental care they need. Instead, depressed people may ask for prescriptions for physical ailments, and use their prescription drugs to treat their emotional pain. [11]
Rural Areas
In particular, shortages of mental-health providers are prominent in rural areas where the opioid epidemic hit the hardest. Some have suggested that providing mental health care to those suffering from chronic pain may help detangle the relationship between pain and depression.[12]
Virtual Reality Therapy
Dr. Skip Rizzo has been working since the 1990s to use virtual reality to treat mental illness. [13] In an "early clinical trial of the software found that "after an average of seven sessions, 45 percent of those treated no longer screened positive for PTSD and 62 percent had reliably improved."[14]
The Virtual Reality Medical Center uses simulation technologies for:
- Treating patients with anxiety disorders
- Training for both military and civilian populations
- Enhancing various educational programs
Benefits of VR Therapy
- Faster than traditional therapy and desensitization[15]
- Practice these skills in situations in which you previously experienced anxiety, allowing the skills to generalize more easily to real world settings[16]
- Can do some sessions in between office session at home, cuts down on the number of sessions people need[17]
Free Mental Health Apps
[need evidence]
Tools & Resources
TR - Improve Detection & Treatment of Mental Health Conditions
Resources for Suicide and Substance Use Prevention in Youth
2017 SAMHSA Webinar on Suicide and Substance Abuse among Young People and includes best practices for prevention and intervention.
SAMHSA has a new list of organizations and resources updated May 2018 with many different types of resources and organizations. (This should be investigated and specific links added throughout the OCRH.
Scorecard Building
Potential Objective Details
Potential Measures and Data Sources
Potential Actions and Partners
Resources to Investigate
RTI - Improve Detection & Treatment of Mental Health Conditions
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