1. Community Outreach, Referral and Early Intervention (CORE)
Division of Prevention and Behavioral Health Services
Division of Substance Abuse and Mental Health 1

2. Delaware History ( ) 2

3. *DPBHS/DSAMH case records 2004-2013
It’s a process…
94% of individuals receiving treatment in DE’s public mental health system for psychosis related disorders are adults however, the median age of onset for psychosis is 16 years old;
1 in 4 cases in the adult system have dropped out of high school;
2 of 3 cases are unemployed;
Services most commonly accessed by adults are crisis and inpatient services.
*DPBHS/DSAMH case records 3

4. A divide between divisions
DSAMH
DPBHS 4

5. Executive Order: Now Is The Time
Closing gun background check loopholes;
Banning military-style assault weapons and high-capacity magazines;
Making schools safer;
Increasing access to mental health services for transitional age youth.
WH.GOV/NOW-IS-THE-TIME 5

6. Executive Order: Now Is The Time
Support individuals ages 16 to 25 at high risk for mental illness
Efforts to prevent school shootings and other gun violence can’t end when a student leaves high school. Individuals ages16 to 25 are at high risk for mental illness, substance abuse, and suicide, but they are among the least likely to seek help. Even those who received services as a child may fall through the cracks when they turn 18. The Administration is proposing $25 million for innovative state-based strategies supporting young people ages 16 to 25 with mental health or substance abuse issues. 6

7. Community Outreach, Referral and Early Intervention (CORE)
PIER
Outreach
Assessment/Engagement
Preventive Service
Youth Coordination
Public education
Advocacy
Peer-to-peer 7

8. Psychotherapeutic Services Inc.
CORE: Administration
Delaware CORE
Psychotherapeutic Services Inc. 8

9. Organizational Structure9

10. Susan Cycyk M.Ed., CRC Principal Investigator, DPBHS Chuck Webb Ph.D.
Co-Investigator,
Gerard Gallucci
M.D., M.H.S.
Co-Principal
Investigator ,
DSAMH
Gwen Derr M.B.A
Project Director,
DPBHS 10

11. CORE: Clinical Team New Castle
Mary Diamond MD
Team Leader,
PSI
Sinchen Sanchez MSW
Social Worker,
Sinchen McDuffy MS
Social Worker,
PSI
Chuck Webb Ph.D.
Clinical Back-up,
DPBHS 11

12. CORE: Clinical Team New Castle
Springer Building, Holloway Campus, DHSS 12

13. CORE: Clinical Team Kent/Sussex
Christine Hanna-Ronald MSN
Team Leader,
PSI
Samantha Eklund
Social Worker,
Angela Williams MS
Social Worker,
PSI
Tracy Washington MSW
Clinical Back-up, 13

14. CORE: Clinical Team Kent/Sussex
630 West Division Street , Dover DE (PSI) 14

15. Occupational Therapy and Supported Ed/Voc Occupational Therapist
Rosemary Lanza OTR\L
Occupational Therapist
Melissa Clendaniel
Educational/
Vocational Advocate 15

16. Youth Coordinator Evaluation Evaluation Geeta Kotak Youth Coordinator
Ryan Beveridge Ph.D.
Timothy Fowles Ph.D.
Briana Haut Psy.D.
Evaluation
Geeta Kotak
Youth Coordinator 16

17. Transition Team Name Title Organization Barbara Messick
Family Coordinator
DPBHS
Carl Gartner
Nemours Emeritus Program
Alfred I. DuPont Hospital
Jim Lafferty
Executive Director
Mental Health Association
Emily Vera
Assistant Director
Yasser Payne
Associate Professor
University of Delaware
Dubard McGriff
Community Organizer
PAR/The People’s Report
Yolanda Jenkins
Executive Assistant
Regina Johnson
Youth Coordinator
Eileen Cozzi-Bodnar
Coordinator, OEBP
Daniel Jones
Psychologist

18. Step 1: Training Didactic hours Consultation frequency Assessment 7
Structured Interview of Psychosis-risk Symptoms (SIPS)
Bi-monthly
Prevention 40
Clinical
Bimonthly
Multi-family Group
Occupational Therapy
Supported Education /Vocation
Monthly
Outreach
Psychiatric
Quarterly 18

19. Step 2: Outreach 1-3% Prevalence Rate19

20. Community Mapping Tool
Key Stakeholders
DPBHS
Supportive Community Allies
YMCA
Elected Officials
MHA
DSAMH
West End Neighborhood House
Transition Team
Churches
State Police
Employers
NAMI
Parent Information Centers
DOJ
Child Welfare
Military
Community Activists
La Red
Insurance Companies
La Esperanza
LACC
First Responders
EAPs
**Boys & Girls Club
CDCP
New Castle High Schools
(## public, ## private)
Individual Practitioners
CORE
Public Colleges & Universities (##)
Behavioral Health Agencies
Crisis
Alternative Schools
Pediatricians
Kent
High Schools (## public, ## private)
CAC
District Offices
GPs & NPs
Residential & Psychological Tx Facilities
Private Colleges & Universities (##)
**Kent Middle Schools
(## public, ## private)
Medical Professional Groups
Sussex
High Schools (## public, ## private)
**New Castle Middle Schools
(## public, ## private)
Hospitals
Public Health Centers
**Sussex Middle Schools
(## public, ## private)
Medical Community Contacts
Academic Contacts
and Supports
**Indicates future population

21. Health Disparities Year 1-1.5 Phase 1 19801,19802,19803,19804,
19805,19808, 19809,19810,
19703,19732,19710,19735,
19736,19711,19717,19712
Sussex County
Phase 1
Year 1-1.5 21

22. Health Disparities
Phase 2
Years 2.5-5 22

23. Latino Outreach: Year 1 Latino 19805 20% Families 19947 21%
Spanish pamphlet;
Bilingual clinicians on both teams;
Translating website, presentation, and voic message. 23

24. African American Outreach: Year 1
Families % %
Committee to coordinate inner-city;
Community based service;
C-TECC tracking referral/admission rates. 24

25. Outreach: Media 25

26. Outreach: Screening 26

27. Step 3: Assessment & Engagement
Rapid ( short DUP for FEPs)
Phone screen in 2 days;
Assessment in 9 days;
Admissions in 16 days.
SIPS: Sensitivity = 100% ; Specificity= 73% at 24 months;
Joining
Most comfortable (e.g., where, with whom)
“What do you want to do?” 27

28. Case Example 28

29. Step 4: Prevention Services
‘Prevention’, not ‘treatment’
Prodrome Secondary
FEP Tertiary;
150 youth in 4 years;
Multi-family groups
Community based,
Linguistic homogeneity,
Address negative symptoms. 29

30. Step 5: Evaluation Outcomes Symptoms (positive, negative);
Functioning (social, vocational);
Substance use;
Education or employment;
Social embeddedness;
Stigma .
Effects
Main;
Moderated (e.g., race; ethnicity);
Anecdotal (e.g., LGBT). 30

31. Step 6: Sustainability Fee-for-service model;
Sustaining uncovered services;
Hospital admission rates. 31