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Joan Englund is the executive director of the Mental Health & Addiction Advocacy Coalition, a group of 129 member organizations working to increase awareness of the issues faced by Ohioans living with mental illness and addiction disorders and to advance policies that positively affect their lives. The overarching goal of the coalition is to improve access to mental health and addiction services for individuals and their families by improving state and local policy.
Interact for Health: The Mental Health & Addiction Advocacy Coalition operates two hubs serving the Northeast and the Southwest regions of Ohio. How do the issues—and potential solutions—differ between the two regions?
Englund: In general, the issues depend on the demographics and geography of the region. Access to services is more available and convenient in urban counties where transportation infrastructure is stronger, where it is easier to recruit a workforce, and where a larger population creates enough demand for specialized services. Southwest Ohio has more rural counties than Northeast Ohio, which means more communities in the Southwest Hub need more resources and infrastructure to support individuals with behavioral health needs. In comparison, Southwest Ohio has a higher unintentional overdose death rate, while suicide deaths are comparable in both hubs. However, Brown County has the highest death by suicide rate out of all the MHAC's 13 hub counties. In Southwest Ohio, improving access includes advocating for local funding and support for mental health and addiction services, developing a stronger workforce, and recognizing the unique socioeconomic and cultural characteristics in the region in order to address the present issues.
Interact for Health: Everyone is clamoring for resources, particularly due to the increased need for mental health and addiction treatment services brought on by COVID-19. The coalition has nearly 130 members. How do you balance their needs?
Englund: The MHAC's hub directors and state program and policy director are responsible for supporting a cross-section of its membership based on the region they work within. This allows us to create personal relationships with members in the hubs and at the state level, so we can check in with them regularly. The MHAC's quarterly Policy and Advocacy Committee meetings, within its hubs and at the state-level, are an opportunity for members to raise and discuss issues as a group. We often find that issues faced by one member organization are happening across the region and/or state, which allows us to streamline support for many members at once and allows them to learn from each other's approaches in responding to issues.
Interact for Health: What is the most immediate next step needed to address the opioid epidemic in Ohio?
Englund: Improving and expanding the network of community services that fall under harm reduction and/or recovery supports are needed immediately to address the opioid epidemic. Once again, due to demographic, geographic, economic and other differences across communities, there is likely not one right answer to addressing the opioid epidemic across the state of Ohio; however, finding strategies that expand or strengthen recovery-oriented systems of care and community systems that support individuals in recovery would really serve the people of Ohio.
Interact for Health: In April, the coalition and Children's Defense Fund-Ohio released "Mind the Gap: Creating a Robust Continuum of Behavioral Health Care for Young Ohioans," a research report that identifies unmet local needs of youth in Ohio. What actions do you hope those findings will inspire?
Englund: We hope our findings will do the following:
Interact for Health: Your Southwest Hub, which represents Brown, Butler, Clermont, Clinton, Hamilton and Warren counties, has identified workforce development as one of its priorities for 2021-2022. What are your plans for that?
Englund: The development of the behavioral health workforce is important for all of Ohio, and as such, is a priority in both MHAC Hubs and in our state-level work. In Southwest Ohio, our plan includes reducing stigma surrounding community behavioral health and the populations it serves, identifying and promoting strategies to recruit and retain diverse and culturally competent workers, including strategies to minimize barriers to entering the field and obtaining licensure, and creating and supporting relationships between higher education and community behavioral health. This work will also include looking at emerging strategies in care coordination that support the behavioral health needs of individuals. In addition, the Southwest Hub Policy & Advocacy Committee created member work groups to focus on workforce development and racial disparities in behavioral health.
Interact for Health: You have been in your position since 2003. What is the most important lesson you've learned during your tenure?
Englund: Policy change is difficult and often takes an incredibly long time to achieve—but keep at it. Come at the issue with different voices, at different times, from different angles. Your window will open. Just keep at it.
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