BY DAY 6

Respond to  two of your colleagues’ postings by proposing at least one challenge they might encounter when implementing one or more of the strategies and explain why. Then explain how your colleague could overcome that challenge. 

SHANNON

Social Problem 

The social problem I chose is suicide prevention among veterans.  This has become a staggering problem and we are losing too many veterans. Veterans tend to have typically higher rate of suicide rates than the general population (Wood, 2020.) Veteran suicide prevention is an extremely important topic needing to be addressed.

Five Strategies to Address and Prevent the Problem 

1. Bring awareness to the new Veterans Crisis Line (VCL) number. Previously veterans were able to call the VCL at 1800-273-8255, then press 1. As you can imagine if you are in a crisis that may be hard to remember. Currently, it has become much easier for a veteran can dial 988 than press 1. By simplifying and shortening it to a 3-digit number much like 911, it makes access much easier. The Veterans Crisis Line is a core component of the Veteran Affairs suicide prevention strategy (IIgen, 2022.) I would try to promote and advertise as many places as possible to get the word out. In fact, put the number in your phone, you can help prevent veteran suicide by sharing.

2. Lethal means Safety. Firearms are the primary method of suicide amongst veterans and active-duty military (Hoyt, 2021) As veterans are trained to utilize weapons as a part of their job in service, weapons are a natural part of their environment. As a veteran myself and working with veterans many are very proud gun owners and not very willing to give them up freely. By training and giving classes on how to safely store your weapon, storing it unloaded, in a safe, with a gun lock you are allowing veterans a choice to keep their weapons safe rather than feeling forced to give them away.

3. Real-time response teams are available across Veteran Affairs nationwide. I currently am involved with the Veterans Mental Evaluation Team (VMET.) The VMET team is a co-response team utilizing a VA Police officer and VA Clinician. We respond on and off property to calls for suicidal veterans and acute mental health crises. While they have had programs with our local partners, it was a first of its kind nationwide. We are now a full-time program and working with the VA’s innovation experience team to spread the program across the country. We are now up to 8 programs across the country!! As a part of this program, we also complete follow-ups after the crisis to help them figure out the barriers leading to the crisis in the first place. We have saved 200 veterans who without intervention would have lost their lives and gone on over 5200 calls for service.

4. Not all veterans have easy access to mental health services. According to the Department of Veterans Affairs (VA) Office of Rural Health (ORH), rural veterans are less likely than nonrural veterans to access mental health services, either through the Veterans Health Administration (VHA) or the private sector ( VA ORH, 2015 Links to an external site. ).  There are many factors that can attribute to this, possibly lack of transportation, and fewer facilities or providers to see them. By having telehealth, a veteran can meet with their provider on a phone, computer or tablet and have a face-to-face from their home.

5. Peer Support System. Having peers of their own available to get assistance and communicate with can be a great tool to utilize for veterans. Community-based veteran peer efforts are showing to be a promising public health approach to preventing veteran suicide (Beehler,2021.) Veterans relate to other veterans as if they are family due to the bond they have after serving. I cannot tell you how many times I hear from veterans they feel like can’t always talk to a provider because they feel they do not understand what they went through. By having a peer system, you are providing them with a tool and someone they can feel more comfortable speaking to.

Reasoning for Prioritizing and Time and Resources  

Having resources such as these in place are easy means and most are cost-effective. The prevention methods are generally an easy way to train staff and promote and advertise, with exception of the VMET team. VMET will require staffing, but as the program has shown it is reducing numbers. However, you can easily start as a pilot program and not have to incur any staffing costs at the start of the program.   Grants can be accessed to get financial means for the supply cost for many of these prevention methods, as suicide amongst veterans has become a public health issue and more money has become available. Lethal means and 988 crisis line only take minutes to share with someone, you can pass out gun locks and advertise easily. Having a crisis team, access to telehealth and peer support provide a community and means to build rapport and can be utilized ongoing before, during, and after a crisis.

References

Beehler, S., LoFaro, C., Kreisel, C., Dorsey Holliman, B., & Mohatt, N. V. (2021). Veteran peer suicide prevention: A community-based peer prevention model.  Suicide & Life-Threatening Behavior,  51(2), 358–367.  https://doi.org/10.1111/sltb.12712Links to an external site.

Department of Veterans Affairs, Office of Rural Health (VA ORH). (2015).  Annual report. Retrieved from  https://www.ruralhealth.va.gov/docs/ORH_Annual_Report_2015_FINAL.pdfLinks to an external site.

Hoyt, T., Holliday, R., Simonetti, J. A., & Monteith, L. L. (2021). Firearm lethal means safety with military personnel and veterans: Overcoming barriers using a collaborative approach.  Professional Psychology: Research and Practice,  52(4), 387–395.  https://doi.org/10.1037/pro0000372Links to an external site.

Ilgen, M. A., Price, A. M., Coughlin, L. N., Pfeiffer, P. N., Stewart, H. J., Pope, E., & Britton, P. C. (2022). Encouraging the use of the Veterans Crisis Line among high-risk Veterans: A randomized trial of a Crisis Line Facilitation intervention.  Journal of Psychiatric Research,  154, 159–166.  https://doi.org/10.1016/j.jpsychires.2022.07.047Links to an external site.

Wood, D. S., Wood, B. M., Watson, A., Sheffield, D., & Hauter, H. (2020). Veteran Suicide Risk Factors: A National Sample of Nonveteran and Veteran Men Who Died by Suicide.  Health & Social Work,  45(1), 23–30.  https://doi.org/10.1093/hsw/hlz037Links to an external site.

SARAH

Social Problem

The continued rise in opiate use amongst adults in the rural area of Fayette County, Pa, even after the mandated ASAM alignment by the Department of Drug and Alcohol Programs and major insurance providers in the state.  Discrimination continues with this solution. The lack of acceptance from people within the communities remains an issue, and people who use opiates but choose to receive MAT are now faced with another social barrier, the lack of NA/AA meetings in this county.

Five Strategies to Address and Prevent the Problem

Strategy 1

Engage key stakeholders to help educate the community about medication-assisted treatment for opiate use and bring awareness to the continued discrimination and rise in the number of persons who use opiates. Collaborate with these stakeholders every week over the course of a month to create an action plan.

Strategy 2

After a month of meeting with stakeholders, develop a plan to initiate consistent communication within the community providing education about the social problem and the solution as it is now, as well as providing education about the medication-assisted treatment programs and the discrimination that contributes to a reoccurrence of use. This would not be very time-consuming and could be planned as an event within the different communities over the course of a month. Advertising, flyers, and social media posts can help to get the attention of community members. Positive language flyers can be posted in the meetings to bring awareness.

Strategy 3

Reach out to the targeted population to organize a planned survey so that we can create an organized schedule specifically tailored to meet the needs of those individuals who want help without discrimination, those who are working on a treatment plan and want to continue to successfully utilize medication-assisted treatment, and those who use opiates but would consider treatment options if the resources were available. This strategy would be time-consuming and done over the course of 6-months at different locations.

Strategy 4

 Collaborate with local treatment centers, medication-assisted treatment clinics, and certified recovery specialists to locate and create a safe space for NA/AA meetings and groups specifically tailored to help those on medicated-assisted treatment to help avoid discrimination within the next 3 months.

Strategy 5

Contact and collaborate with the Department of Drug and Alcohol Programs, and Medicaid providers (Beacon, Community Choices Behavioral Health, Magellan, and Perform Care) to help spread awareness throughout the state of Pennsylvania. This may be time-consuming, but these are the organizations responsible for mandating this solution.

Reasoning for Prioritizing and Time and Resources

To identify the range of possible stakeholders and design strategies to engage them individually and collectively (Stroh, 20105). I also want to make sure that everyone has a shared vision of how to help the social problem.  This will help people face the current reality of the social problem, what is happening, and why (Stroh, 20105). People need to accept their responsibility for helping to create this reality by expressing continuous discrimination. It is important that the targeted population give their input and ideas toward the change to help create better successful outcomes. It is also important to schedule these meetings during times of availability. These programs understand the importance of creating a safe space for these individuals so that a reoccurrence of use does not occur, and so they are not faced with any additional social barriers. These specific organizations expect every treatment center in Fayette County, as well as the state of Pennsylvania, to implement treatment modalities designed specifically to cater to the needs of each individual. What they did not take into consideration are the social barriers that the persons are faced with when attempting to gain housing, or even attend a meeting in this area. When a person is faced with this discrimination, they often return to using a substance.

References

Stroh, D. P. (20105). Systems Thinking for Social Change. White River Junction: Chelsea Green Publishing.

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