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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.

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providing sustainable tobacco cessation services to the mental health community

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
Charyn

Sutton

4.6.1947 – 12.30.2004

once upon a time
Once upon a time…..
  • ‘Providers’
  • ‘Clients’ and ‘Patients’
  • a few ‘Questioners’
questioners from the field
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
Some of the Questioners in Marin County:
  • 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
Mental Health & Tobacco Cessation Working Group
  • 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
The Challenge: Ask

Linda Reed Day Services Survey*

  • 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* Unpublished survey conducted by Amy Rogers, OTR/L, Linda Reed Day Services, 2004.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
Linda Reed Day Services
  • 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
Canyon Manor
  • 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
Lessons Learned:

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

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
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.
slide12
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 sideeffects.

Lasser, K., et al. JAMA, 284:2606-2610. November 2000

why not
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
Contact Information

Beth Lillard

Marin Tobacco Cessation Project Director

Bay Area Community Resources

(415) 444-5580 ext 334

blillard@bacr.org