You may hear the term Evidence-Based Practice, or EBP, to describe a skills-development or treatment program and wonder what that really means. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines Evidence-Based Practice as a practice that based on rigorous research that has demonstrated effectiveness in achieving the outcomes it is designed to achieve.
In practical terms, this means a treatment or program is provided to children and families in a way that was successful for other people with similar needs. When agencies implement a program as designed, children and families are more likely to see positive results. Many evidence-based practice programs can help children and families learn skills and strategies that help them manage challenges their family faces and improve communication.
Program models need time before they can become an evidence-based practice. Researchers review information reported during program participation, including outcome data. They also consider how long changes last after the program ends. Improvements and change must match the goals of the program. If a practice does not achieve the intended goals, changes may be made to the model. When others provide the same program, the results should be similar to show that the program model does what it says it does.
Delaware has been increasing use of evidence-based practices in the child and adult serving systems. There is a lot of research about prevention, early intervention, treatment, and skills development programming. This information helps agencies, like ours, and community-based providers choose effective programs that will be helpful to Delawareans.
The Division of Prevention and Behavioral Health Services offers a number of evidence-based practices. We are working to improve our ability to deliver evidence-based services and add new research-proven methods into our system.
You can learn more about our treatment services here: http://kids.delaware.gov/pbhs/services-offered.shtml and our prevention programs here: http://kids.delaware.gov/pdfs/pbh-guide-to-programs-and-services.pdf
To learn more about evidence-based practices, visit the following web-based resources:
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This article provides Alcohol Facts and Statistics across a range of areas that impact functioning and mortality.
According to the National Institute of Health’s National Institute on Alcohol Abuse and Alcoholism an estimated 88,000 people (approximately 62,000 men and 26,000 women) die from alcohol-related causes annually. This sobering statistic makes alcohol the fourth leading preventable cause of death in the United States.
In 2014, alcohol-impaired driving fatalities accounted for 9,967 deaths (31 percent of overall driving fatalities).
• More than 10 percent of U.S. children live with a parent with alcohol problems, according to a 2012 study.
Prevalence of Underage Drinking
• According to the 2015 National Survey on Drug Use and Health (NSDUH), 33.1 percent of 15-year-olds report that they have had at least 1 drink in their lives.
• About 7.7 million people ages 12–20 (20.3 percent of this age group) reported drinking alcohol in the past month (19.8 percent of males and 20.8 percent of females).
Prevalence of Underage Binge Drinking
• According to the 2015 NSDUH, approximately 5.1 million people (about 13.4 percent) ages 12–20 (13.4 percent of males and 13.3 percent of females) reported binge drinking in the past month.
Prevalence of Underage Heavy Alcohol Use
• According to the 2015 NSDUH, approximately 1.3 million people (about 3.3 percent) ages 12–20 (3.6 percent of males and 3.0 percent of females) reported heavy alcohol use in the past month.
Consequences of Underage Alcohol Use
• Research indicates that alcohol use during the teenage years could interfere with normal adolescent brain development and increase the risk of developing Alcohol Use Disorders.
• In addition, underage drinking contributes to a range of acute consequences, including injuries, sexual assaults, and even deaths—including those from car crashes.
Alcohol and College Students
• According to the 2015 NSDUH, 58.0 percent of full-time college students ages 18–22 drank alcohol in the past month compared with 48.2 percent of other persons of the same age.
Prevalence of Binge Drinking among College Students
• According to the 2015 NSDUH, 37.9 percent of college students ages 18–22 reported binge drinking in the past month compared with 32.6 percent of other persons of the same age.
Prevalence of Heavy Alcohol Use among College Students
• According to the 2015 NSDUH, 12.5 percent of college students ages 18–22 reported heavy alcohol use in the past month compared with 8.5 percent of other persons of the same age.
Consequences of Alcohol Use among College Students
• Researchers estimate that each year 1,825 college students between the ages of 18 and 24 die from alcohol-related unintentional injuries, including motor-vehicle crashes.
• 696,000 students between the ages of 18 and 24 are assaulted by another student who has been drinking.
• 97,000 students between the ages of 18 and 24 report experiencing alcohol-related sexual assault or date rape.
• Roughly 20 percent of college students meet the criteria for Alcohol Use Disorder
• About 1 in 4 college students report academic consequences from drinking, including missing class, falling behind in class, doing poorly on exams or papers, and receiving lower grades overall.
Alcohol and Pregnancy
• The prevalence of Fetal Alcohol Syndrome (FAS) in the United States was estimated by the Institute of Medicine in 1996 to be between 0.5 and 3.0 cases per 1,000.
• More recent reports from specific U.S. sites report the prevalence of FAS to be 2 to 7 cases per 1,000, and the prevalence of Fetal Alcohol Spectrum Disorders (FASD) to be as high as 20 to 50 cases per 1,000.
Alcohol and the Human Body
• In 2013, of the 72,559 liver disease deaths among individuals ages 12 and older, 45.8 percent involved alcohol. Among males, 48.5 percent of the 46,568 liver disease deaths involved alcohol. Among females, 41.8 percent of the 25,991 liver disease deaths involved alcohol.
• Among all cirrhosis deaths in 2013, 47.9 percent were alcohol related. The proportion of alcohol-related cirrhosis was highest (76.5 percent) among deaths of persons ages 25–34, followed by deaths of persons ages 35–44, at 70.0 percent.
• In 2009, alcohol-related liver disease was the primary cause of almost 1 in 3 liver transplants in the United States.
• Drinking alcohol increases the risk of cancers of the mouth, esophagus, pharynx, larynx, liver, and breast.
The State of Delaware’s Department of Services for Children, Youth and their Families (DSCYF) issued a Request for Proposals (RFP) for licensed medical practitioners to provide psychiatric services to children served in the following settings:
• two residential mental health treatment centers (RTCs), which also provide outpatient day treatment,
• staff-secure and secure care juvenile justice settings (two detention centers, one secure rehabilitative treatment facility, and three staff-secure cottage programs), and
• outpatient Bridge Psychiatric Services.*
The deadline to submit proposals for this solicitation is August 8, 2017 at 2:00 pm. You can view the bid information and status details here: CYF17005-PSYCHIATRY
This solicitation is open to any qualified provider of psychiatric services, including:
• sole proprietors,
• partnerships, corporations,
• limited liability corporations,
• either for-profit or not‐for‐profit.
Regardless of the type of contractor, direct treatment services under this RFP may be provided by a Delaware-licensed psychiatrist experienced with children and adolescents, or Psychiatric-Mental Health Nurse Practitioner-Board Certified (PMHNP-BC) with active prescriptive authority.
To sign up to receive notification about solicitation opportunities and to review this solicitation, visit the State of Delaware Bid Solicitation Directory: http://www.bids.delaware.gov/.
If you would like more information about our Request for Proposal and contracting processes, please visit the following webpages:
The Children’s Department wants all interested parties to have an opportunity to submit proposals in response to this RFP. Please share this information with agencies and practitioners you know who might be interested in providing psychiatric services to children served by DSCYF.
*Bridge Psychiatric Service, for purposes of this RFP, is defined as transitional psychiatric care needed when a DPBHS client temporarily has no current provider relationship, e.g., after leaving inpatient hospital care but before a first appointment with a new outpatient practitioner, in order to continue medications.
When a family is in the midst of an emotionally charged situation involving a child who is struggling emotionally or behaviorally, it can be hard to decide what to do and how to calm things down. Our Mobile Response and Stabilization Services (MRSS) are here to help. MRSS is available to address the needs of children through age 17 and their families anytime, day or night, including weekends and holidays. Family members and other concerned people can access MRSS by calling 1-800-969-HELP.
We expanded how we define a crisis to meet the needs of young Delawareans and their families. This approach will make it easier for children and families to get help when they need it to defuse situations that affect family functioning. MRSS provides timely assistance that assesses risk/safety and works collaboratively with children and families to identify their needs, strengthen their support network, and make connections to community resources.
The goals of our Mobile Response and Stabilization Services are to
• determine if emergency services, such as ambulance or police, are needed
• assess risk and plan for safety
• defuse emotionally charged crisis situations
• connect young people and their families with helpful resources
• help families develop plans to safely maintain children in their homes, schools, and community
• refer children and families to treatment services based on risk and needs ranging from outpatient treatment to hospitalization for psychiatric or crisis stabilization needs
DPBHS has contracted with two provider agencies to deliver this new service throughout the State. Legacy Treatment Services maintains the statewide call center and provides mobile response services in Kent and New Castle Counties. Delaware Guidance provides mobile response services in Sussex County.
You can learn more about our Mobile Stabilization and Response Services by attending an upcoming community meeting:
Sussex County on July 12, 2017 from 4:00 – 6:00 pm
Delaware Technical and Community College Owens Campus
Theater in the Arts and Science Center
21179 College Drive
Georgetown, DE 19947
New Castle County on July 20, 2017 from 4:00 – 6:00 pm
100 Rockford Drive
Newark, DE 19713
Kent County on July 27, 2017 from 4:00 – 6:00 pm
Dover Behavioral Health
725 Horsepond Road
Dover, DE 19901
If your child is injured, has a medical emergency, or there is immediate threat of harm to themselves or someone else; call 911 before calling the MRSS hotline.
For mental health or substance use emergencies involving people who are 18 years of age or older, contact the Delaware Division of Substance Abuse and Mental Health (DSAMH) Crisis Intervention Services as follows:
In Northern Delaware: 800-652-2929
In Southern Delaware: 800-345-6785
The Delaware Prevention Coalition is presenting the 10th Annual Teen Summit this summer. Join other teens August 5, 2017 for this free event at the Chase Center on Wilmington’s Riverfront. The Teen Summit will feature workshops, celebrity panels, food, and giveaways!
*This project is funded by the Substance Abuse Block Grant from the Substance Abuse and Mental Health Services Administration via the Delaware Division of Prevention and Behavioral Health Services
One in five children and youth experience a mental health challenge. Mental health is an important part of children’s health and well-being. Mental health problems can affect a child’s ability to succeed in school, at work, and in the community, but mental illness in children can be hard for families to identify. Even when you know the signs, it can be hard to separate normal childhood behavior from a mental health problem. Children cannot always explain their needs due to age, developmental stage, or vocabulary.
Some general symptoms that indicate a child may have a mental health need include:
• Changes in mood, behavior, or personality; including severe mood swings
• Difficulty concentrating that interferes with school or other activities
• Feeling sad, withdrawn, or irritable for long periods of time
• Intense emotions including fears or worries that affect functioning
• Physical symptoms (unexplained weight changes, sleeping problems, headaches and stomachaches)
• Decline in grades and school performance
• Changes in social interactions
• Loss of interest in activities once enjoyed
• Physically harming self or others, or making plans to do so
• Substance use or abuse
Getting help for children when these behaviors first appear can prevent or reduce the risk of developing a behavioral health problem. There are prevention programs throughout Delaware that help children and families add new skills to their toolbox to address early signs and symptoms.
Talk to your child’s doctor or a mental health provider if you are concerned your child may have a mental illness. Only a licensed professional can diagnose mental illness. Check with your insurance or Medicaid provider to find outpatient mental health treatment providers in your area. If your child is uninsured, or is a Medicaid recipient who needs more than outpatient treatment, contact DPBHS Access at 1-800-722-7710.
If you would like to read more about identifying behavioral health concerns in children and adolescents, the following resources may be helpful:
• National Alliance on Mental Illness – Know the Warning Signs
• Mayo Clinic – Mental Illness in Children
• National Institute of Mental Health – Treatment of Children with Mental Illness Fact Sheet
Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This post is part of an ongoing series to increase awareness and improve understanding of the effects of the opioid epidemic on families in Delaware. This post focuses on efforts by the Delaware Division of Professional Regulation to provide oversight of opioid prescription.
On 1/27/17 the Delaware Division of Professional Regulation (DPR) sent an email notification to all Delaware-licensed prescribers about important new regulations for the safe prescribing of opiates. The new regulations went into effect on April 1, 2017.
The new regulations
• establish basic standards for prescribing opiates safely
• give new requirements on prescribing opiates for acute episodes as well as for chronic, long term pain management
Two Information fact sheets were included:
Delaware Prescription Opioid Guidelines for Patients
Delaware Prescription Opioid Guidelines for Health Care Providers
Both fact sheets include the following information:
• 228 people in Delaware died of drug-related deaths in 2015. Many of those deaths were related to prescription drugs.
• Almost 2 million Americans abused or were dependent on prescription opioids in 2014.
• As many as 1 in 4 people who receive prescription opioids long term for non-cancer pain in primary care settings struggle with addiction.
The fact sheet for patients answers the following:
• What are opioids?
• What are the dangers of opioids?
• What are the alternatives for pain management?
• How do I take opioids?
• How should I store and dispose of my medications?
The facts sheet for prescribers requires prescribers to document treatment agreements with patients and explains components of informed consent for opioid medication:
• The drug’s potential for addiction, abuse and misuse.
• The risks of life-threatening respiratory depression associated with the drug.
• Potential for fatal overdose as a result of accidental exposure, especially children.
• Neonatal opioid withdrawal symptoms.
• Potential for fatal overdose when interacting with alcohol.
• Other potentially fatal drug interactions, such as with benzodiazepines.
We at the DPBHS appreciate the efforts of the Delaware Division of Professional Regulation to establish basic standards for prescribing opiates safely and creating new requirements for prescribing opioids for pain management. Please share this information with families, especially those who have a history of substance use or who are prescribed opioid medication.
How did we come to call our blog the Bounce Back Bulletin – Cultivating Change for Resilient Communities? We wanted the title to reflect our vision of Resilient Children and Families Living in Supportive Communities.
The selection process included people who manage and provide our services (staff) and people who utilize our services (youth and families). Our creative staff submitted catchy title ideas that connected to our overall mission and vision! Next, our family-run organization, Champions for Children’s Mental Health, and the youth coordinator for the federally funded CORE program identified family members and youth to review the submissions and select a title.
The fantastic team of young people and caregivers liked several entries, so they had trouble narrowing it down to just one! As a result, they combined elements from three entries to create the chosen title. We were thankful to have youth and family voice in our decision-making process. As a result, the blog title is as meaningful to those who use our services as to us.
For us, the title conveys the strength children and families possess and their ability to develop resilience that helps them bounce back from adversity. As a division, we help families hone their skills and strengthen that resilience through our prevention, early intervention, and treatment supports and services. When children and families have access to the help they need, when they need it, their ability to bounce back improves. Our focus is to help youth and families enhance their personal competency and skill to make changes, promote success, and develop resilience. As agents of change, we help families navigate the system and provide support as they make informed decisions about care. Our prevention team also does this on a community level, helping community-based organizations develop capacity to promote change and resilience.
Strong communities are more resilient – our goal is to nurture youth, families, and communities as they grow in skill, competency, and confidence. We hope you see this message in the name of our blog, and it helps remind all of us that youth, families, and communities are important assets. By supporting and strengthening them, we all come out stronger and better.
Written on: June 12th, 2017 in Community
Welcome to the Bounce Back Bulletin, the official blog of the Division of Prevention and Behavioral Health Services (DPBHS). This first post kicks off our blogging adventure, an effort to share information with a wider audience and make news about children’s behavioral health more accessible. We seek to reach families, partners, providers, and stakeholders by moving our previously published newsletter to this blog format.
For those of you who may not be familiar with our work, I would like to take this opportunity to introduce the Division. DPBHS is one of four divisions within the Department of Services for Children, Youth, and their Families (Delaware Children’s Department). We serve Delaware families through prevention and early intervention programs that promote safe and healthy children, nurture families and communities, support social and academic success, and improve early identification of needs. We also serve eligible families of children and youth (through age 17) with behavioral health treatment needs. We work with a network of providers and partner agencies to provide an array of programs, supports, and services throughout Delaware. By leveraging state and federal resources, we have been able to bring new programming and evidence-based practices to Delaware in expand access and improve quality.
Children and youth today face many challenges and helping them navigate childhood and adolescence can be tricky. In addition to sharing information about our work and programs, we will use this forum to help families and communities learn more about ways to promote emotional well-being for children. We will share both local and national information and work to help you make sense of what it all means.
We hope you will join us on this new blogging journey; I am looking forward to seeing where it leads us.
Visit again soon!
Director, Division of Prevention & Behavioral Health Services