Creating Opportunities

Do you know anyone who needs healthcare for mental illness or addiction? Whether you realize it or not, you probably do. Statistically, between twenty and twenty-five percent of people require mental health or addiction services at one time or another. If you live in Clinton County, and have used any of our local mental health services, chances are you have received those services from a program touched by Peter Trout. Trout currently holds the position of Director of Community Services for Clinton County, where he is responsible for the planning activities and regular oversight of the county’s outpatient clinic on Ampersand Drive. He is also tasked with oversight for all of the New York State funding delivered to Clinton County which flows through his office and into area agencies and programs involved in addiction and mental health services and developmental disabilities.

The County’s clinic offers both mental health and addiction services treatment, and has also started to partner with local primary care providers to allow patients to receive services at their physician’s office. “Some people are uncomfortable, or unable to seek services at a separate location,” Trout noted. “By serving patients where they are already going, we can integrate mental health care with primary care and hopefully make it that much more accessible.” Currently, clinicians are co-located in seven offices county-wide, and it is Trout’s hope that expansion will continue as demand increases.

This initiative is one of ten items in an ambitious agenda laid out in the 2016 “Local Services Plan for Mental Hygiene Services,” a plan created by the Clinton County Community Services Board. Loaded with words like “integration”, “partnership”, and “collaboration”, the plan addresses not only behavioral health services, but ambulatory detox services, heroin and opiate use, affordable housing, transportation services, and suicide prevention. It aims to address not only the behavioral issues faced by community members, but the ancillary issues which may hinder people from receiving treatment. “It’s difficult to expend efforts to increase your mental health and deal with an addiction,” Trout said, “but if you are trying to do this while you’re homeless, the effort is multiplied.” To achieve success, the plan depends on delivery of services not just by the county, but by numerous partner agencies.

Champlain Valley Family Center, NAMI, Evergreen Townhouse Community, and Behavioral Health Services North are all agencies which receive a portion of their funding from the State of New York, and that funding flows through the county and is administered “with arm’s length oversight,” Trout explained. “The county’s role is to maximize the strengths of each agency, to help them succeed so they can find a way to meet the needs of clients and empower them to provide the necessary services.”

Part of the driving force behind this initiative is the change in the current healthcare landscape. At any visit you make this year to a physician or non-primary clinician, you will likely be screened at intake to evaluate your risk for depression and addictive behaviors such as smoking. Quality initiatives in primary care have begun to require all providers to evaluate and respond to a patient’s mental health issues. “It is a big mistake to separate the brain from the body—and people are recognizing the value of addressing mental health needs as a routine part of physical wellbeing.” Trout said. Only when we can discuss mental health issues as easily as we do physical health issues will the stigma for seeking treatment be reduced. “Ultimately, our goal is early identification and referral to treatment services.”

Trout also hopes that an increase in awareness of mental health issues will lead to a reduction in the suicide rate. Another of the ten priority outcomes for 2016 is the adoption of a Zero Suicide system-wide approach to suicide prevention. “Suicide rates in Clinton County are nearly twice that of the rest of the state, approximately 14.7 per 100,000 people as opposed to 8.3 per 100,000 statewide,” Trout noted. “The lack of willingness to seek treatment for addiction and depression, coupled with the stigma of seeking help, create an environment in which elevated risk is present.” To help address this issue, Trout and the Community Services Board have implemented a community-wide prevention and intervention training initiative and hope to establish a postvention team to intervene in traumatic death by suicide and to implement an anti-stigma campaign through quarterly community events promoting behavioral health education.

Trout also hopes that an increase in the awareness of mental health issues will lead to a reduction in the suicide rate. Another of the ten priority outcomes for 2016 is the adoption of a Zero Suicide system-wide approach to suicide prevention.

Another important and topical initiative for 2016 is the development of an interdisciplinary action plan to reduce the impact of heroin and opiate use. “There is a direct correlation between the rise of opioid addiction and deaths from it,” Trout stated. Local partners in this effort include every agency you might expect, and others you might not have considered. “Probation, law enforcement, political partners, DSS, agencies, and caregivers all have a seat at the table when we are discussing how best to combat our current epidemic. We want everyone to be talking about this issue since it will take collaboration to create community-wide solutions.”

With so many high-priority goals, the challenges are numerous. But some are the same challenges that service providers across the board expect: manpower and funding. “This is a time when the opportunity for us to improve health care is great. The field is historically underfunded and we lack infrastructure and depth of personnel. But as we transition from a fee-for-service model to a value-based healthcare system, there may be a new ability to define what it looks like to truly integrate our services into the larger healthcare landscape,” Trout emphasized. “It is my goal to open this dialogue, to create opportunities for greater access to services and greater opportunity for early intervention for addiction and mental health issues.” By carefully stewarding funds and creating and nurturing partnerships, Peter Trout is improving the outlook for mental health services for all county members.