Summer 2019
masthead
broken tree at randolph house
Training & Preparation Is Key

All PLACES ACFs, Supportive Living and Permanent Supportive Housing units are supplied with flashlights, battery and hand cranked weather radios, and other safety equipment. ACFs conduct various types of disaster drills once a quarter on each shift, drills that are tailored to their individual facility.

“When new staff is onboarded, they get initial training in emergency preparedness,” Jeff explained. “Each facility has its own Emergency Training, so it is specific to that facility. Any time a sub is hired, they’re also trained.”


PLACES Night at Dayton Dragons

Continuing a tradition begun last year to celebrate its 30th anniversary, PLACES is having a special night for friends and family at Fifth Third Field.

Dayton Dragons vs. Lake County (OH) Captains
August 3, 2019, 7 pm
Ticket and hat: $12
Call Dragons Box Office:
(937) 228-2287


ACEs Are Risk Factors for Adult Health and Behavioral Problems

The landmark CDC/Kaiser Permanent Adverse Childhood Experience Study (1995-1997) found that almost two-thirds of participants reported at least one ACE, and more than one in five reported three or more ACEs. As the number of ACEs increases so does the risk for the following:

Alcoholism and alcohol abuse

Chronic obstructive pulmonary disease

Depression

Fetal death

Health-related quality of life

Illicit drug use

Ischemic heart disease

Liver disease

Poor work performance

Financial stress

Risk for intimate partner violence

Multiple sexual partners

Sexually transmitted diseases

Smoking

Suicide attempts

Unintended pregnancies

Early initiation of smoking

Early initiation of sexual activity

Adolescent pregnancy

Risk for sexual violence

Poor academic achievement


5 Strategies for Preventing ACEs:

» Strengthen economic supports for families

» Change social norms

» Quality child care and education early in life

» Enhance parenting skills

» Intervene to lessen harms and prevent future risk

Source: “We Can Prevent ACEs” Video from the Centers for Disease Control and Prevention


Tornadoes Rip through Dayton

PLACES’ North Main Adult Care Facility was damaged when 140 mph winds roared through, but all residents are safe.

tornado damage

Late Monday evening, May 27, category EF4 tornadoes slammed into Harrison Township, Trotwood, Beavercreek and elsewhere, causing severe damage to property and trees. By a lucky coincidence, the staff of PLACES’ adult care facility (ACF) on North Main had rehearsed their tornado drill just the day before.

“This is the first time PLACES has dealt with a disaster of this magnitude,” said residential services coordinator Jeff Stokoe. “All of our locations in the city of Dayton were on full alert because we didn’t know where the tornado would hit.”

Jeff drove to the North Main site around 1 a.m., but was held back by first responders because power lines were down. He explained the situation and asked them to go check out the house. Local Harrison Township police and fire squads are aware of the ACF, but the disaster was so huge that first responders had been called in from outlying jurisdictions.

tornado damage

Moments later two Dayton police officers approached Jeff and volunteered to go check on the residents. The house was without power, one window was damaged, and there was extensive tree damage. Residents and staff were sequestered in the basement, but safe. Although the danger was over, police didn’t allow them to leave the facility.

A damage assessment was done by Jeff and Rob Jones, who handles maintenance. Normally executive director Roy Craig would be part of the team, but his home had been severely hit as well, so Jeff and Rob developed the initial plan for keeping residents safe and making repairs.

Although structural damage to North Main was negligible, state regulations would classify the home as uninhabitable due to the lack of air conditioning, because of power loss. By law, temperatures may never go above 81° F, as psychotropic medicines make residents sensitive to heat.

The Tangy Court Housing First facility also suffered a power outage for two days, but was not deemed uninhabitable because Housing First properties don’t have same maximum temperature requirements.

Finding Temporary Homes

As soon as the eight North Main residents were allowed to leave the building, they were transported to other PLACES ACFs. Four residents went to Marty’s House in Huber Heights and four to the Trotwood facility. Guardians, family members and behavioral health partners were notified. Staff was also reassigned to both sites so residents would see familiar faces at their temporary home. Medications, medication logs and limited personal belongings were transported along with residents.

Although not responsible for the buildings where PSH tenants are housed, PLACES is responsible for tenant safety. Staff made contact to notify tenants of the impending emergency and instruct them to go to a safe place. PLACES takes attendance to know if clients and tenants are in their buildings or out visiting.

Resettlement & Cleanup

North Main’s residents were relocated back home eight days later, on June 5, after fallen trees that blocked the driveway were removed, thanks to 16 volunteers from SouthBrook Christian Church in Miamisburg.

“The staff of North Main did a phenomenal job of making a hard situation work,” Jeff said. “The staff at Huber and Trotwood were great, too – very welcoming.”

As repairs were happening and residents resettled, the need to document and bill for services continued. PLACES is currently using a wi-fi hot spot to transmit records electronically. It was decided that keeping paper records and then uploading six weeks of information would be too much of a burden. Phone and Internet service should be restored this month.

The Aftermath

While major disasters are traumatic for everyone, they’re especially difficult for people experiencing mental illness.

“They understand a tornado and what it is, but there’s the personal impact on them,” Jeff said. “When residents exited the basement all the trees were down on the ground. They were afraid to see that. One person said to me, ‘We got lucky, didn’t we?’ I told him, ‘Karen [North Main’s overnight staff] took good care of you. You were in a safe place.’”

Jeff gave kudos to the residents for managing their own emotions. He acknowledged that staff had a significant contribution in making that happen, too. “I didn’t have to do any interventions other than handle one complaint about food!” he said.


The Impact of ACEs: Part Two

In the previous issue we provided an overview of the health risk from Adverse Childhood Events (ACEs). Here we explore the impact on substance abuse and suicide.

By Brian Wlodarczyk, LISW-S, Director of Clinical Services

As reported previously, we are at the 20 year anniversary of a landmark study by the Division of Violence Prevention at the Centers for Disease Control and Prevention (CDC), in partnership with Kaiser Permanente, which found a clear link between adverse childhood experiences (ACEs) and behavioral health and substance abuse issues.

Since then, research has continued into the impact on ACEs on various populations and ways in which we can mitigate these effects.

ACEs Linked to Suicide and Drug Abuse

We know that ACEs increase the risk of a myriad of public health issues, from lifetime depressive episodes to high risk sexual behaviors, sleep disturbances, fetal mortality, decreased birth weights, diabetes, heart attacks, even poor dental health. It’s no surprise that they are also linked to suicide and drug abuse.

According to the CDC, Ohio’s rate of suicide is 13.5 deaths per 100,000 individuals, about equal to the national average of 13.4 per 100,000 residents. It is notable that having any adverse childhood experience increased the likelihood of a suicide attempt by two- to five-fold over a person’s life, according to a 2001 study. Individuals who reported having six or more ACEs were nearly 25 times more likely to attempt suicide, according to a study reported in the Child Abuse & Neglect journal in July 2017.

Mental Health Awareness Month
Drug Deaths High, But Declining

When it comes to drug abuse, more than 46 people per 100,000 in Ohio died of overdoses in 2017, a higher rate than any other state besides neighboring West Virginia, which saw almost 58 overdose deaths per 100,000 people in 2017.

PLACES is part of Montgomery County’s Emergency Room Overdose Notification System (MC-ERONS), which is designed to provide quick identification of county overdoses and offer providers greater opportunity to engage, assess and link clients to appropriate services. Though this is just one of numerous county initiatives, the impact of Montgomery County’s efforts can be seen in the significant reduction of unintentional overdose deaths over the past year (see chart above).

Creating a Healthy Future

Creating healthy mental and physical beginnings for children diminishes the likelihood that the effects of trauma will repeat from one generation to the next. Epigenetics, the science of how social or environmental factors turn genes on or off, has shown that trauma can be passed on to the next generation. For example, you may have a predisposition for depression or heart disease, but what turns on or off the genes for that disease may begin early in your childhood, even prenatally.

The good news that our brains and bodies work together to heal symptoms of stress begs the questions, “How do I make this happen,” and “What can I do to help myself and others heal?”

Parents who make social connections, find support for themselves and encourage their children’s social and emotional growth provide a blanket of comfort and protection against stress and trauma.

What You Can Do To Help

Begin by understanding your own ACEs. Discover your ACE score (search online for “ACEs test”) and find out how resilient you are. Take action … for yourself, your family and your community. The repercussions from ACEs enter classrooms, courtrooms, and make news headlines. Everyone pays the price for adverse childhood experiences.

Educate yourself about what adverse childhood trauma looks and feels like. Learn what as an individual you can do to help yourself and the children in your life. Grow in resiliency and wellness to counteract the symptoms and effects of childhood trauma and to protect upcoming generations. Bring healing, empowerment and safety to work with you. James Redford, producer of a documentary on resiliency, said there needs to be “an opening of the heart.

”Invest in community programs that promote healthy family relationships, encourage positive parenting techniques and provide early learning opportunities in places with well-educated and caring staff. Healthy, secure and happy childhood experiences created by adults capable of regulating their own emotions does more to ensure the longevity and success of future generations than all the pharmaceuticals and medicine available today.

The issue of ACEs belongs to everyone, and within everyone lies the problem as well as the solution.


New Efforts in Minority Mental Health Care

July is National Minority Mental Health Awareness Month. The Office of Minority Health (OMH) of HHS is joining with partners at the federal, state, local, tribal and territorial levels to raise awareness* about mental illness and its effects on racial and ethnic minority populations.

Mental Health Awareness Month

Despite advances in health equity, disparities in mental health care persist. The Agency for Healthcare Research and Quality (AHRQ) reports that racial and ethnic minority groups in the U.S. are less likely to have access to mental health services, less likely to use community mental health services, more likely to use emergency departments, and more likely to receive lower quality care. Poor mental health care access and quality contribute to poor mental health outcomes, including suicide, among racial and ethnic minority populations.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA):

» In 2017, 41.5% of youth ages 12-17 received care for a major depressive episode, but only 35.1% of black youth and 32.7% of Hispanic youth received treatment for their condition.

» Asian American adults were less likely to use mental health services than any other racial/ethnic group.

» In 2017, 13.3% of youth ages 12-17 had at least one depressive episode, but that number was higher among American Indian and Alaska Native youth at 16.3% and among Hispanic youth at 13.8%.

» In 2017, 18.9% of adults (46.6 million people) had a mental illness. That rate was higher among people of two or more races at 28.6%, non-Hispanic whites at 20.4%, and Native Hawaiian and Pacific Islanders at 19.4%.

*OMH is launching a free and accredited e-learning program: Improving Cultural Competency for Behavioral Health Professionals. This new program was developed to help build knowledge and skills related to the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (National CLAS Standards).