Beyond the Spectrum

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Beyond the Spectrum

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1. Beyond the Spectrum Challenges in Dual Diagnosis Supports May 8, 2008 John L. Martin, Director

2. The Ohio System Two Cabinet Level Departments Ohio Department of Mental Retardation & Developmental Disabilities (MR/DD) Ohio Department of Mental Health (MH) Ohio has a strong County Board system Each County has its own MR/DD Board and its own MH Board Counties raise a significant amount of their own money to support services

4. In Ohio, MR/DD and MH work with partners to support two interlocking efforts that assist individuals with dual diagnosis. Community Centers of Excellence A Professorship of Dual Diagnosis Both efforts are housed at Wright State University, School of Medicine which is located in Dayton, Ohio.

5. Structure of Interlocking Efforts

7. Community Centers of Excellence Wright State is the lead agency which subcontracts with two partners. The work is spread as follows: Wright State: Assessments and consultation on difficult cases, referral is through the Department. OSU Nisonger Center: Coordinates training across the State. Case Western: Research around effectiveness of training approaches through field trials trying to increase research around dual diagnosis.

8. Wright State receives direction from an Advisory Board Bill Adelsberger (Provider Organization) William Klykylo, MD (Wright State) Mark Davis (Provider Organization) Cynthia Dulaney, Ph.D (Xavier University) Joshua Ebling, MSW, LISW (Advocacy Organization) Susan Franer, RN, MSW, CNS (University of Cincinnati) Cindy Ison (Advocacy Organization) Michael Schroeder (MH Staff) Carol Heil (CB MR/DD Staff) Bettie Meadows (MR/DD Staff) Glenn McCleese (MR/DD Staff) Richard Norman, MD (MR/DD Staff) Heather Kendall (CB MR/DD Supt) Richard Steinbrenner (Advocacy Organization) Julie Gentile, MD (Wright State) Edward Comer (Wright State) Mike Shoenhofer (MH Board)

9. Wright State as lead agency performs two major tasks. The first is they have a relationship with six clinics in four regions and they subcontract with these clinics to do assessments. Approximately 700 individuals are followed by these clinics.

11. The second task they perform is the establishment of interdisciplinary and intersystem teams for the purpose of increasing local capacity of care of individuals with dual diagnosis. Currently we have 35 teams in 66 counties.

12. Community Development as of 02/08 Western Region 9 Teams/21 Counties Southern Region 11 Teams/21 Counties Central Region 7 Teams/14 Counties Northern Region 9 Teams/10 Counties Formalized Team – 35 Teams Representing 66 Counties Counties that are involved in on-going activities related to improving dual diagnosis services locally without a formalized team (1 county – Summit)

13. Under the leadership of Wright State, these 35 local teams were established and operate as follows: Regional trainings were held to introduce ideas MR/DD & MH designated staff to support Small mini giants were made available to get the teams started (2,000 per county): To apply for a grant, both of the local superintendents (MH & MR/DD) have to sign off and appoint staff to the team. A team leader is assigned. This small team of local experts: Accept referrals Figures out services needed Utilize clinics for assessments Identify training needs Refers/screens difficult cases to Wright State for assistance

14. Annually, a statewide conference is held on dual diagnosis, jointly sponsored by the two State Departments and the CCOE: In addition to the training that happens, the team leaders from the 35 teams get together to learn from each others experiences.

15. Summary Program is funded by ODMR/DD and ODMH Utilizes expertise of three universities Funds a professorship of dual diagnosis Establishes a network of local clinics and local teams – up to 700 persons are actively followed Coordinates training and networking on both a local and statewide level Any given quarter, an average of 25 trainings occur to close to 200 persons (local team members & provider staff). Up to 100 professionals (medical students, etc.) receive trainings in dual diagnosis. Annual Statewide conference is held.

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