Growth • wellness • Community
Focusing on the individual CARE, HOPE & HEALTH K B B h .o r g — 2210 n . e l d o r a d o B o u l e va r d — K l a m at h Fa l l s
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Growth • Wellness • Community
Mental health is just as important as physical health Klamath Basin Behavioral Health — 2210 N. eldorado boulevard — 541.883.1030 — kbbh.org
Inside: Mee t K B B H’s a d mini s t r at i v e t e a m: Page 3 prov id in g s erv i c e s i s a mi s s i o n o f d i gni t y, c a re: Page 3 pro m ot in g he a lt h a nd wel l ne s s f o r fa mil ie s: Page 7 prov id in g f o r s t ud en t s’ men ta l he a lt h need s: Page 9
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Day t re at men t — a deeper l e v el o f s t ud en t c a re: Page 12
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F os t er Plus — m a k e a d ifferen c e in a c hil d’s l ife: Page 14 C o mmuni t y c o rrec t i o n s — acc e s s in g t re at m en t: Page 15 You M at t er to K l a m at h — Sui c id e pre v en t i o n: Page 17 Welc o me to t he ne w (o nl ine) K B B H s erv i c e s: Page 21
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B eh av i o r a l he a lt h — a pro gre s s i v e a pproac h: Page 22
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Talk with us
This publication was created in partnership with the Herald and News — June 2019
Klamath Basin Behavioral Health provides these services to people of all ages in the Klamath Basin Mental Health Counseling Addiction Treatment Community Outreach Programs Residential Services Veterans Services Psychiatric Services School Based Services Therapeutic Foster Care Suicide Prevention & Intervention 24/7 Crisis Response
Growth • Wellness • Community
Get to know KBBH’s administrative team
Klamath Basin Behavioral Health
A mission of dignity and care
Stan Gilbert, LMFT, LPC Chief Executive Officer Stan Gilbert joined KBBH in 1986, bringing a history in progressive mental health care and a passion for ending the stigma associated with mental illness and substance use disorders. Under his leadership and progressive vision, KBBH grew from a child and family treatment center serving less than 50 consumers, to the largest behavioral health provider in Southern Oregon, serving over 8,000 children, adolescents, and families. A community organizer and thought leader at a local, state, and national level, Gilbert sits at the forefront of social growth in Klamath County and holds a steadfast commitment to the development, delivery, and administration of behavioral health programs that empower individual change.
Provider keeps the patient at forefront of services
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hen one walks through the doors of the Klamath Basin Behavioral Health office in Klamath Falls, they’ll be greeted with a friendly, caring staff.
What is mental health? ‘Feeling good about yourself, feeling good about the world you live in, feeling hope, finding a place to manage your life going forward, that there is a way to find happiness and joy and connectedness to the world around you. That is mental health.’ — Stan Gilbert, KBBH CEO
Amy Boivin, MA, QMHP Director of Clinical Services Amy Boivin joined KBBH in 1996 incorporating a thoughtful, consumer-focused leadership strategy to traditional clinical oversight. With a strengths-based organizational leadership approach, her authenticity, compassion for the individual, and unwavering belief that change is possible has created inspired and committed teams. Building on a professional background spanning child and family therapy to residential program oversight and operation, Boivin’s direction created the scaffolding for KBBH’s expansion into nearly 30 individualized programs and services across Klamath County. Her steady, forwardthinking approach to behavioral health care has been integral to KBBH’s exponential growth and success.
By GERRY O’BRIEN: H&N Editor
And, rest assured, they will not feel alone. A staffer will be there to greet them and help with their preliminary needs for their mental health issue. From there, a Care Navigator will be assigned to their case and then a therapist will draw up an assessment plan that is closely followed to provide the best possible outcome for their needs. ‘This is what we do’
KBBH is the community mental health program for Klamath County. It is also the local mental health authority, which means it has statutory responsibilities for ensuring there is an appropriate mental health system available for the public. It ranks as one of the best in Oregon for the size county it serves. “Really, our job is to try to create a more behaviorally healthy community,” says KBBH CEO Stan Gilbert. At any one time, the county could have up to 16,000 people in need of mental health services, about 25% of the county’s population on average, according to the Centers for Disease Control. “We identify needs in the community and establish sustainable programming to address those needs,” Gilbert says.
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Get to know KBBH’s administrative team ‘One of our priorities is to reduce the stigma of mental illness; to normalize it for those seeking help when you need help. The stigma is what really stops people from seeking help. We work really hard to eliminate that.’
Liz Maddalena, MBA Director of Operations Liz Maddalena joined KBBH in 2006 seeking the opportunity to merge her success in the U.S. Air Force and fast-paced corporate world with an opportunity to put her servicefocused heart to work creating impact for others. Maddalena brings a unique ability to transform big ideas into sound strategy development with her business management acumen and financial direction and was instrumental in building KBBH’s capacity for expansion. Her authenticity, accountability, stewardship of resources, and extensive knowledge of business governance and organizational management grounds KBBH’s core competencies in intelligent business strategy.
— Liz Maddalena, KBBH director of operations
The mental health services range from the serious illnesses such as bi-polar disorders and schizophrenia to substance abuse treatment, depression, helplessness, homelessness, loneliness or disengagement from society.
Patty Card
Curbing the stigma
Director of Administration
“One of our priorities is to reduce the stigma of mental illness; to normalize it for those seeking help when you need help,” says Liz Maddalena, director of operations. “The stigma is what really stops people from seeking help. We work really hard to eliminate that.” As the stigma associated with mental illness breaks down, more people are willing to come forward and say that they have issues and need help, says Director of Administration Patty Card. “One of our primary strategies is to talk about your health, the whole person. When we talk about health as a human being, there is no division between your physical health and your mental health,” says Amy Boivin, Director of Clinical Services. A new approach It is a new approach, but a logical one. If one is homeless, or out of work, or not eating right; those priorities take precedence over seeking mental health care. “We try to make it easy and barrier-free to seek services from us. You can call, walk in the door, or email us,” Gilbert said. “As for the costs, I would rather that the person seek out help first, and we’ll worry about the finances later. If you are hurting and things are not right in your life, if you approach us, we’ll figure out the payment. The most important thing is to get here.”
Patty Card joined KBBH in 1984 combining her love and loyalty for Klamath County with an unwavering commitment to the health and happiness of its most vulnerable citizens. KBBH’s longest-term staff member, Card’s dynamic, high-energy approach to consumer-focused behavioral health care has served as the central hub for 35-plus years of local impact. Her global perspective on over 30 individualized programs and services is driven by decades of experience in overcoming barriers to bring the benefit of dignified behavioral care to those in need.
Contact Klamath Basin Behavioral Health Visit
Stop by Klamath Basin Behavioral Health at 2210 N Eldorado Ave., Klamath Falls, Oregon 97601
Call
541.883.1030
FAX
541.884.2338
info@kbbh.org
Online
Connect online: kbbh.org & facebook.com/kbbh1
Growth • wellness • Community
Programs and services offered through Klamath Basin Behavioral Health
Mental Health Services • • • • • •
Adult Outpatient Services Child, Adolescent, and Family Outpatient Services Care Navigation Mobile Crisis Services Oregon Health Plan Enrollment Psychiatry
Addiction Treatment Adult therapeutic recovery groups include: Motivation, Relapse Prevention, Women’s Support, Men’s Support, Communication and Recovery, Anger and Recovery, Parenting in Recovery, Boundaries, Nutrition, Mindfulness, Life Changes, and DUII Treatment. Adolescent therapeutic recovery groups include individualized groups for male and female youth.
Community Programs • •
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Department of Human Services, Child Welfare Department of Human Services: In-Home Safety and Reunification and Strengthening and Preserving, and Restoring Families Healthy Families Integrated Care Juvenile Department Services School Based Mental Health Services School Based Services
Enhanced services For adults: • Adult Residential and Respite Services • Assertive Community Treatment • Case Management for Adults • Early Assessment Screening Alliance • Peer Support Services • Supported Housing Rental Subsidy For children & adolescents: • Foster Plus • Pineview Youth Residential Program (Behavioral Rehabilitation Services) • Psychiatric Day Treatment Services for Children and Adolescents • Wraparound
‘We have seen people who are homeless, living on the streets with substance abuse, who are now living independently and self-sufficiently. We see that change and know it can happen. We see it all the time.’ — Stan Gilbert, KBBH chief executive officer
The Local Mental Health Authority or LMHA as it is known in Oregon, employs 213 staffers. Staff are available not only at the main office at 2210 N. Eldorado Ave. in Klamath Falls but are present in nearly all the city and county schools, alternative education programs, Klamath County Community Corrections, the Department of Human Services, Sky Lakes Medical Center, and at the Klamath Basin Senior Citizens Center. So one can easily approach them at many of these outreach sites, thereby helping to remove some of the stigma barriers. “We will meet people at the library, the emergency department, wherever they are,” notes Card. “Our 24/7 mobile crisis team goes out with law enforcement, as well.” A new website was just launched that gives viewers a much easier way of finding the services they may need. See it at www.kbbh.org. not Just therapy sessions “We are not just about counseling, though that always helps,” Gilbert says. “We do a lot of training to make sure our staff are good at what they do. Sometimes medication is the important thing, and we have a wealth of those who can prescribe drugs. It’s a good tool, but not the only tool.” “For some people it’s really valuable to understand that they are not alone; that others are going through the same thing. We have support groups where they can work on it.” There is also a host of skills training to help people manage their daily lives. “How you view a problem will dictate how you deal with that problem,” Gilbert said. “Some people believe the situation they are in is hopeless where we can show them it is not. “We have seen people who are homeless, living on the streets with substance abuse, who are now living independently and self-sufficiently. We see that change and know it can happen. We see it all the time.”
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The minute a client walks in the door, they connect with another human being who helps guide them through all the options. “A big part of what we do is build a relationship with our patients. At the point of engagement when people come to see us, they see there is hope and things can be better,” he said. a biGGer toolbox of help
Technology also plays a large role in the services provided. “We now have a much better ability to find out root causes of illness,” said Boivin. “Today, we have more of an understanding of what creates holistic health. It includes how you are physically taking care of yourself; are you eating well, sleeping well, have a purpose, have a safe place to live, have caring people around you? We wrap all of that into a treatment plan.” a team model
The minute a client walks in the door, they connect with another human being who helps guide them through all the options. “Our job is to partner with them to help them achieve their goals and talk about various options. That first contact should be about understanding who this person is,” Boivin said. They are treated with dignity and respect, always. A Care Navigator will direct that person to right services. Then, a therapist may take over to help with the assessment, diagnosis and writing a treatment plan tailored to their needs. The bulk of the work is done by peer support, case management, and counseling groups. But there is also help with housing and finding work. The patient is tracked all the way through the process until they are able to be out on their own. KBBH offers life skills training in the home, too. “The reason KBBH is as successful as it is, is the heart and commitment of the staff, the dedication,” notes Maddalena. “I can’t say that enough. Everyone is here because of some personal commitment for doing this work. Everyone here recognizes the dignity of the person and there’s a love and a passion for the work.”
K b b H
A HISTORY SERVING THE COMMUNITY
1978 Steering Committee Formed 1994 Department of Human Services partnerships begin 1997 Psychiatric Clinic launches
2013 Substance Use Disorder Services launch 2014 Mobile Crisis Team launches 2015 Early Assessment and Screening Alliance launches 2016 Kingsley Field partnership begins
2016 Assertive Community Treatment launches
1980 Klamath Child and Family Treatment Center launches Child Day Treatment Program
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1995 School Based Services launch
1995 Klamath Kids Count campaign raises $2.8 million, KBBH partners with Sky Lakes Medical Center to renovate Eldorado facility into Mabel Liskey Henzel Pavilion
2002 Healthy Family Program launches 2013 KBBH assumed responsibility for all adult services in Klamath County
2011 Transition to electronic health records 2013 KBBH designated by State of Oregon as Certified Mental Health Program and Local Mental Health Authority 2015 Older Adult Mental Health Services launch
2014 Youth Behavioral Rehabilitation launches
2015 School Based Mental Health launches, School based Services expands
2016 Behavioral Intervention Court launches
2016 Peer Support Services launch
2016 Jail Diversion Services launch
2017 Care Navigations services launch
2017 Foster Plus launches
NEXT UP FOR KBBH •
1986 Adolescent Day Treatment Program launches
1982 Counseling Services Program launches
Sobering and Crisis Walk-In Clinic construction begins Corrections Residential Monitoring Program begins Corrections Mentoring Program begins
2016 Supported Employment launches
2017 Certified Community Behavioral Health Clinic (CCBHC) Demonstration begins
2018 Mobile Crisis Team expands to 24/7
2018 You Matter to Klamath Suicide coalition launches in response to SB561
2018 OIT Master’s Internship Begins
2019 On-site Primary Care Integration
Growth • Wellness • Community
Healthy Families
Promoting health and wellness for families Program supports parents in cultivating, strengthening and nurturing, positive relationships with their children H&N Staff Report
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or Klamath County parents of newborn babies, a regular home visit from a parenting specialist can offer needed support and help build lifelong family bonds.
Healthy Families is a free statewide home visiting program that helps promote health and wellness for families with children ages 0 to 3. They served 102 families in Klamath and Lake counties in 2018, and recent data shows 73 percent of participating Klamath families reported improved parenting skills within six months. Healthy Families of Klamath and Lake County is part of an accredited multi-site state system with Healthy Families America (HFA). Participation is voluntary and focuses on strengthening the parent-child relationship to assure healthy child growth and development. Home visitors are Qualified Mental Health Associates trained to support parents in cultivating and strengthening a nurturing, positive relationship with their baby at each visit. Eligible families receive information on topics like child development, infant care, and community resources for new families. Every new parent can fill out a questionnaire in the hospital that determines their eligibility for Healthy Families home visiting. H&N Staff Photo
Carol Coker, supervisor of the Healthy Families program shows donated clothing stored in the program’s donation room.
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Bringing home a new baby can be a challenge and parents may qualify due to a variety of additional stressors including need for behavioral health or social support, single parent status, relationship challenges, etc., Healthy Families contacts them. Then, a specialist brings a “welcome baby” gift to the family home, tells them about the program, and invites them to join. Currently, six Healthy Families support specialists are responsible for visiting nearly 80 local families to offer parental support, education, and referrals to additional resources. Program Supervisor Carol Coker said specialists visit client families once per week for the first six months of a baby’s life, then visits taper off to meet specific needs of the parents. Caseloads and hours are limited, she said, to build relationships and encourage true connections between specialists and families. Spectrum of topics
Coker said specialists discuss a spectrum of topics with parents, from safe bottle holding, to the importance of eye contact, regular bonding and reading. “You want to hold the baby, get eye contact, and fill up on oxytocin,” Coker said. “Mom is going to fall in love and dad is going to fall in love when they’re holding them, they’re looking at them.” She said it is important that specialists start the program within the first three months of a baby’s life, while parents are forming strong care habits and looking for information on raising happy and healthy children. Helping parents create a safe and nurturing environment for their new baby is another key outcome and Healthy Families specialists
embody an infant mental health approach, with the belief that early, nurturing relationships are the foundation for life-long, healthy development. “Research shows when you can teach best practices of parenting, problem-solving and long-term plans early on, the entire family will benefit. Specialists help parents identify and plan to achieve personal goals. Sometimes, it can be as simple as finding the time, money, child care and transportation to practice selfcare. Other times, it’s a long-term plan to go back to school or achieve a career goal. “We break it all down into little steps — that’s how we do life,” said Amy Boivin, KBBH director of clinical services.
Eligible families receive information on topics like child development, infant care, and community resources for new families.
Focusing on support
Still, the overwhelming focus is to support a strong parent-child connection. “I used to think every parent instantly fell in love with their babies and knew what to do,” Coker said. “It can be more challenging for some. Making that connection isn’t always easy, and it’s beautiful when it clicks.” Coker said visits typically last one hour but can go longer in the event of a crisis, high stress situation, or challenging phase of growth and development. She believes the program is so successful because it is a choice parents make for themselves, not a requirement. “We’re just in-home cheerleaders,” Coker said. “People don’t care how much you know, they want to know how much you care. Just having someone walk alongside you ... that’s pretty huge.”
Ge t ting in touch • Call: 541.883.1030 • Online: www.kbbh.org, and Healthy Families of Klamath & Lake Facebook page • Visit: 2210 N. Eldorado Ave.
Growth • Wellness • Community
KBBH in the schools
Providing for students’ mental health needs Therapists see success stories for students working through trauma, depression, anxiety, suicidal thinking
By HOLLY DILLEMUTH: H&N Staff Reporter
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rauma can manifest itself in a variety of ways, prompting the need for a personal, oneon-one approach for every youth who comes to or meets with mental health personnel at Klamath Basin Behavioral Health. The county’s mental health service provider offers in-house treatment through the day treatment program that includes an academic curriculum. The program is similar to residential level of care that adults can receive, but students don’t stay overnight.
KBBH is also contracted with the Klamath Falls City School District to provide mental health services in all of its schools. This year, KBBH is looking at ways to expand its services to more schools within the Klamath County School District. Individual outpatient counseling for children and teens is also available at KBBH’s main facility on Eldorado Avenue.
H&N photo by Holly Dillemuth
Tara Cobine, supervisor for school-based services through Klamath Basin Behavioral Health, has found her niche overseeing mental health professionals who staff Klamath Basin schools. Cobine brings 15 years experience at Department of Human Services Child Welfare Office to the role.
“We have a lot of kids that are experiencing trauma or have experienced trauma earlier in their childhood,” said Tara Cobine, supervisor for school-based services through KBBH. “We see a lot of depression and anxiety, and a lot of suicidal thinking,” she added.
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The organization also sees success stories of students who engage in their services and are better able to navigate life with the coping skills they gain from working through issues with KBBH professionals. Cobine said she personally has witnessed success stories of students who return later on with accomplishments like high school diplomas and college and career accolades.
‘Many are coming from homes where the parents aren’t really involved or very active with them. We see a large number of homeless teens who are ‘couch surfing’ (living at friend’s homes) or don’t really have a family base that can take care of them. So, we have a lot of teens that are fending for themselves.’ — Tara Cobine, KBBH supervisor for school-based services
“Our purpose, in having a therapist at the school, is to work with kids individually and help them build better coping skills,” Cobine said. “So no matter what’s going on in their life, they’re able to cope with that better and keep their emotional level more stable.” “It’s definitely affirming that we’re doing really good work in the schools and we’re helping where we can,” Cobine added. KBBH started as a mental health services facility for youth in Klamath Falls nearly four decades ago and has since grown to serve all ages as the largest behavioral health service provider in southern Oregon, according to the facility’s new website. High-stress situations
Many of the youth helped by KBBH services are from high stress situations, Cobine said. “Their parents may be struggling with their own mental health issues, or with substance abuse issues or involvement with law enforcement,” Cobine said. “Many are coming from homes where the parents aren’t really involved or very active with them. We see a large number of homeless teens who are ‘couch surfing’ (living at friend’s homes) or don’t really have a family base that can take care of them. So, we have a lot of teens that are fending for themselves.” That’s where the mental health service provider comes in, providing therapy on site at schools in addition to KBBH’s North Eldorado Avenue location. KBBH contracts with the Klamath Falls City School District to staff all city elementary schools and Ponderosa Middle School with mental health providers. This year, Chiloquin Elementary and Chiloquin Junior/Senior High School and Falcon Heights Academy in the Klamath County School District are also staffed with KBBH mental health personnel.
“Our purpose, in having a therapist at the school, is to work with kids individually and help them build better coping skills,”says Tara Cobine, supervisor for school-based services through Klamath Basin Behavioral Health. H&N photo by Holly Dillemuth
Growth • Wellness • Community
“These professionals provide skills-building, they do groups with kids like friendship groups and social skills groups, and they will do some classroom education teaching if that’s requested,” Cobine said. “They provide services and support to the schools in whatever fashion the school needs ... assess kids and refer them to additional services and even refer their families for services, too.” Chiloquin Elementary and Junior/Senior High, Klamath Learning Center, Mazama, Klamath Union, Ponderosa Middle School, Falcon Heights Academy, and EagleRidge High School are currently staffed with therapists from KBBH. Cobine said county schools would like KBBH to add more mental health professionals to additional county schools, as youth in the county face mental health issues as well as in city schools. Technology stressors “The widespread use of technology definitely adds to the issues that are going on, because there’s really no safe place for kids to go now,” Cobine said. “If they are being bullied or harassed at school, in the past, before this new age of technology, they could go home and they could escape that and have a break from it. But now, with kids having cellphones and access to social media nonstop, they’re leaving school but the problems at school are following them through social media. They’re continuing to be traumatized by different things through texting, Facebook, or Snapchat.” Cobine said apps such as Snapchat are unique in that messages disappear after being posted, leaving no trace of the perpetrator. “Some actually can even be anonymous so people can send threats or insults and they don’t even know who sent them,” Cobine said. “I think it’s a different way to amplify it, and I think it’s a lot easier to send insults and threats over a screen when you’re not face-to-face with someone … hiding behind technology gives people a greater sense of bravery.” Each quarter, KBBH compiles a mental health report with data obtained from all schools partnered with the organization to receive services. “Therapists that are housed at the school report numerous successes with kids who’ve been suicidal, and who have developed coping skills and are better able to manage their emotions. They go on and do well in school and are able to be successful in school,” Cobine said. “If your mental health is suffering, you’re not going to do well in school,” she added.
H&N photo by Holly Dillemuth
‘The widespread use of technology definitely adds to the issues that are going on, because there’s really no safe place for kids to go now. ... with kids having cellphones and access to social media nonstop, they’re leaving school but the problems at school are following them through social media.’ — Tara Cobine, KBBH supervisor for school-based services
“If you’re having other issues or other struggles and you have a lot of worries going through your mind, it’s hard to concentrate at school.” Cobine said in-house therapy at schools has also helped reduce the stigma of addressing mental health. “High schoolers for the most part, and junior high schoolers, too, really enjoy coming to therapy,” Cobine said. “For the most part they really enjoy it because it’s convenient,” she added, noting ease of access at schools. “Some kids choose to come to the clinic instead of being seen at school but it’s actually
a pretty small minority. I think it is changing. I think it’s becoming more acceptable in the schools and amongst our teenagers to be involved in mental health treatment. They seem to freely talk about it and they talk about it with their friends.” Cobine said she hopes it’s a sign that teens and adults are overcoming the fear of stigma that can be attached to receiving mental health treatment. “Treating your mental health is just like treating your medical health issues,” Cobine said. For more information, visit KBBH’s new website: www.kbbh.org.
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KBBH: Student Day treatment care
Offering a deeper level of student care Program provides students with coping skills; preparing them for their return to classes in the public schools By HOLLY DILLEMUTH: H&N Staff Reporter
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or students experiencing higher levels of mental health needs, Klamath Basin Behavioral Health (KBBH) operates a day treatment program that aims to prepare students with the highest level of care designed to provide the coping skills necessary to return to classes in public school.
The program is similar to a residential treatment program for adults in a high level of care, although children and youth don’t stay at the center overnight. Students are provided two meals a day, academic classes, and opportunities to participate in fun activities. KBBH contracts with the Klamath Falls City Schools and Klamath County School District to bus students to the facility to receive combined behavioral health and educational services during the day if they cannot yet succeed in traditional classrooms.
H&N photo by Holly Dillemuth
Jay Otero, director of child program services at KBBH, shares about services provided by Klamath Basin Behavioral Health through the day treatment program at the Eldorado Avenue facility.
“The adolescent age is tough on everybody,” said Jay Otero, who serves as Child Program Services Director at KBBH. “That junior high transition to high school, that end of high school – What-am-Igoing-to-do-with-my-life – I’ve got to be an adult now.”
Growth • Wellness • Community
At Day Treatment, located on site at KBBH, students can come as they are, find a calm environment conducive to learning and/or de-escalating, and receive the care and education they need. “We work with some kiddos who have been through the foster care system. We have worked with kids that have come from some pretty rough backgrounds,” Otero said. “They’ve been witness to things that kiddos shouldn’t see.” Otero emphasized the earlier he and others can help, the better the long-term outcomes are for students. “If we can’t help that early on, it could be a life-altering event for them and we want to help stop that before it comes to the point where they can’t be successful,” Otero said. “They’ve come to us, we’re the ones to help – and we will do it.” student ready KBBH has three classrooms and a gymnasium for youth on site as well as a kitchen and cafeteria, where youth are served healthy snacks and two meals a day. A sensory room is also available with ball pit activities aimed at deescalating youth who are experiencing anxiety or other mental health issues. “We utilize day treatment as highlevel care because we don’t want kids leaving our community to go someplace else, go live someplace else,” Otero said. “The closest residential for us is probably Corvallis or Grants Pass. And in that case, the kiddos don’t get that family connection.” Youth who come to KBBH’s day treatment attend classes at their appropriate grade level, with class sizes hovering around 10 or 12 students. Teachers onsite are special education-certified, and are joined by additional teaching specialists in the classrooms. Students also meet with a therapist on site on a weekly basis, and work with treatment specialists and a child psychiatrist. “It’s a team model,” Otero said. “They do team meetings on a regular basis.”
H&N photo by Holly Dillemuth
Otero, a defensive coordinator for a high school football team in Klamath Falls, works well under a team model. He even brings students from the day treatment program to football practice if they are interested, as a way to help them strengthen their social skills. Otero has a background teaching alternative education at the Klamath Falls City Schools district and working in juvenile justice. “Most of the kiddos I worked with had a pretty tough background,” Otero said. “We know that kids thrive in consistency and structure,” Otero added. The hope for Otero and staff is that students do not stay long-term at KBBH but integrate back into public school and go on to live successful lives as adults. “It’s not ideal in the long term, this high a level of care,” Otero said. “We want to see them ultimately be successful in a mainstream educational environment. “It’s all about what else can we do to help out our community,” Otero added.
‘We work with some kiddos who have been through the foster care system. We have worked with kids that have come from some pretty rough backgrounds. They’ve been witness to things that kiddos shouldn’t see.’ — Jay Otero KBBH director of child program services
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Foster Plus
Close to home: Making a difference in a child’s life therapeutic foster homes sought for at-risk children, those with higher needs than traditional foster children Submitted photos
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new statewide campaign launched to reduce the growing deficit of foster homes in Oregon — and in Klamath County — is seeking dedicated parents who want to make a difference in a child’s life.
Formerly known as “therapeutic foster care,” Foster Care Plus is designed for children — usually those in their teens — who have higher needs than a traditional foster care home can provide. Thirteen social service providers have partnered to recruit and certify new foster parents to work with the most at-risk youth in the state. Two families are undergoing the certification process in Klamath County. The campaign’s goal is to create 150 new therapeutic foster beds over the next three years. A therapeutic
foster home provides care for children in foster care who have experienced trauma or disruption in their lives and need extra support to heal and grow. Many of the youth are teens who have experienced few positive adult relationships. Foster Plus is focused on bringing in new foster parents who can help youth heal from their past challenges and make a difference in their young lives. ChallenGes, rewards While it may be a challenge, there are benefits for both the foster parents and child. For one, the home is not operated as a traditional foster care home. There is typically only the one child per home. Further, Klamath Basin Behavioral Health makes available -- for 11 hours weekly -- a skills-building session for the child and the parents. There’s also access to the entire staff at KBBH, a 24/7 crisis support team and counselors are available, too. Foster parents are given 48 hours per month off and receive extra financial support starting at $1,400 per month.
Foster Plus is an effort funded through a grant by the Oregon Department of Human Services. The state saw each individual provider as relatively small when it came to recruiting and certifying higher needs foster parents. DHS believed the 13 providers combining efforts would create a higher level of awareness. “It is meant to stabilize the child’s behaviors so they can step down to regular foster care in a timely fashion,” said Abbie McClung of KBBH. “These children often have unique behaviors stemming from trauma and neglect. They may have trouble functioning in school or a mental health issue. To understand the program better, KBBH holds an introductory meeting for interested parents the fourth Monday of every month, to allow them to see firsthand the training and certification process. It usually takes about three to six months before a household is approved. “The ultimate goal is to assist the youth in gaining the skills necessary to succeed in a less restrictive environment,” McClung said.
Want to le arn more? For more information, visit Fosterplus.org to learn more about a local agency. send questions to nicole rodgers at nrodgers@kbbh.org or 541.883.1030.
Growth • Wellness • Community
KBBH & Klamath County Community Corrections
Providing immediate access to treatment Mental health, addiction services offered for jail and probation populations as an alternative to incarceration H&N Staff Report
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ighty to ninety percent of individuals charged with felonies in Klamath County also suffer from a behavioral health condition. Instead of treating mental illness as a crime, Klamath Basin Behavioral Health has implemented a host of programs to connect criminally charged individuals with behavioral health services.
H&N staff photo
Ryan Cavendish, Klamath Basin Behavioral Health Adult Program Services director attributes the success of treatment for jail and probation populations to a strong relationship and collaboration between KBBH and Klamath County Community Corrections.
Ryan Cavendish, KBBH Adult Program Services Director, said the community mental health program and Klamath County Community Corrections (KCCC) began discussing treatment services for jail and probation populations as an alternative to incarceration in 2015. When KBBH began treatment services in collaboration with Corrections, they started with three employees. Now, program and treatment staff is pushing 30, including a full-time care provider working in the jail. Today, KBBH serves nearly 500 people either on probation or in the Klamath County Jail. This includes 250 to 300 individual assessments per year to begin services. Cavendish attributes the program’s success to a strong relationship and collaboration with KCCC and the Klamath County Jail, proximity to the jail (services are offered both inside the facility and next door), and because probation officers and jail leadership have thoroughly embraced it.
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If someone on probation tests positive for drugs or alcohol, Cavendish said they can walk just a few feet away to get connected with treatment. Prior to KBBH providing treatment programs, Cavendish said individuals incarcerated or on probation struggling with substance abuse could wait up to six months to get help. “The goal was if we have somebody that needs these services, then we could provide immediate access,” Cavendish said. “Almost every time we’re going to give them same-day service now.” Cavendish said KBBH facilitates four treatment groups with 20 to 25 participants in the jail per day. They also offer a mental health screening on every person who comes through the Klamath County Jail. If a person’s screening is positive, they can choose to be connected with programs that fit their needs. Their criminal cases could also proceed through a special court called Behavioral Intervention Court that was established specifically to address the root issues of behavioral health conditions that engender criminal behavior. influence on crime
Cavendish said that untreated behavioral health issues can have a deep impact on a person’s likelihood to commit a crime. If someone struggles with mental illness or addiction, they may not be getting food, shelter, warmth and support needs met. This may lead them to commit a crime, and if the base issue of their illness is not addressed, poor choices can spiral deeper. “If we get them into treatment rather than incarceration — and it’s not always going to work — but what we’re seeing is it is working most of the time,” Cavendish said. “They’re not out there committing more crimes. They have options of engaging and becoming pro-social and allowing for pathways to behavioral health care.” Cavendish said treatment includes residential and outpatient programs that can last anywhere from six months to a
Klamath Basin Behavioral Health facilitates four treatment groups with 20 to 25 participants in the jail per day. Mental Health screenings are also provided for every person who comes through the jail. H&N file photo
‘I don’t know any other county where the jail commander or director of probation could call someone because they are worried about inmates’ mental health!’ — Ryan Cavendish, Klamath Basin Behavioral Health Adult Program Services director
year — or however long is needed. KBBH also follows up with clients after treatment, Cavendish said, and in some cases tries to connect them with housing. In 2015, when KBBH kicked off its corrections and jail based services, Cavendish said they provided 3,310 services — meaning an assessment, jail diversion treatment plan, group therapy session, etc. — to people on probation. They also provided 1,146 services to people in jail. In 2018, Cavendish said they provided 6,819 services to people on probation, and 4,260 services to incarcerated individuals. “It’s really unique in that it’s not a vacuum of services,” Cavendish said. “They get assessed and develop
a treatment track.” KBBH provides 24/7 crisis response services, Cavendish said, which can include immediate help and intervention for individuals in crisis or at risk due to behavioral health symptoms. Respite facility KBBH also provides access to respite care, Cavendish said; if someone is prescribed a new medication and needs to stabilize, they can leave the jail to do so safely in a respite facility. Cavendish said KBBH found its treatment programs reduce recidivism among participants, which he considers the ultimate measure of success.
Treatment can increase communication and trust between clients, probation officers, and treatment providers Cavendish said. Going forward, Cavendish said KBBH plans to enhance its prebooking services by identifying individuals who qualify for care before they are even booked into the jail. Helping participants find stable housing is another future program goal. “For anybody that needs help and is requesting it, we will always be open,” Cavendish said. “I don’t know any other county where the jail commander or director of probation could call someone because they are worried about inmates’ mental health!”
Growth • wellness • Community
Prevention, intervention & ‘postvention’ Basin mental health and suicide prevention coalition laser-focused on breaking down communication barriers
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uicide is always a difficult topic to discuss among parents, children, friends and with the community at large.
When someone takes their own life, especially when it involves a child, there’s a lot of angst and questions, but not much can get to the heart of the problem, nor are there ways to inform the public at large. Facts surrounding the death are frequently kept hidden and discussion is generally taboo except
in generalizations. Now, there is a fairly new mental health and suicide prevention coalition that is breaking down those barriers in ways not seen in Klamath County before. The group is called You Matter to Klamath, with the hashtag #Umatter2Klamath Led by Klamath Basin Behavioral Health (KBBH) it comprises over 28 local agencies who represent a wide swath of the Basin from youth to health care professionals who are laser-focused on suicide prevention. You Matter to Klamath includes mental health counselors, intervention specialists, city and county school district workers, Klamath Tribes members,
law enforcement officials (including District Attorney Eve Costello), teen group representatives and the media — just to name a few. The group is striving to break down the walls that go up when a suicide occurs. It has three points of focus: prevention, intervention and what is called “postvention.” That’s not to say that everything a family is going through is exposed to the public. They are the first concern for the group and their needs, especially their privacy, comes first. “But much like the AIDS epidemic, it’s all about removing the stigma so that people talk openly about it,” said Steve Ware, the supervisor of the Mobile Crisis Team.
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American Foundation for Suicide Prevention — afsp.org/statefacts
As one way to start the public conversation, and to shed light on suicide prevention, You Matter to Klamath organized a May 18 public forum at the Mills Elementary School auditorium, featuring motivational speaker and celebrity personal trainer Rebecca Kordecki, followed by a Town Hall style question and answer panel with professionals from eight local agencies. The panel included representation from loss survivors, the private and public mental health sectors, youth leaders, both local school districts, Veterans advocates, and the Klamath Tribes. suiCide rates Suicide rates in Oregon are higher than the national average and are higher in Klamath County than Oregon, said KBBH CEO Stan Gilbert. Suicide is the eighth lead-
ing cause of death in Oregon and the second leading cause of death for those ages 15 to 34. May and September are statistically the highest months for suicides, said Jenny Wheeler, the team leader for the KBBH Mobile Crisis Team. And in April and May alone, KBBH received some 148 and 151 call outs respectively of its new, 24/7 mobile unit to speak with someone who was struggling with their mental status. Thus far in June, the number of call outs is on track to reach a similar number, said Ware. “From the same period of April through June, there have been 411 crisis screenings reaching out to Chiloquin, Bly, Round Lake and various residences, medical offices and schools in our County. Additionally, crisis staff completed 228 case management services assisting consumers in accessing services,” Ware said.
Suicide is the eighth leading cause of death in Oregon and the second leading cause of death for those ages 15 to 34.
Growth • Wellness • Community
In January 2019, national experts on suicide intervention worked with the group to train counselors, first responders, and prevention specialists to address postvention — how to best communicate with the community about suicide. Key is to get the facts out to the public, but to do so in a way as to not prompt those who may be contemplating suicide to act, and to give the victim’s family time to absorb what has happened without invading their privacy. Under a recent Oregon law, the state’s counties must develop a plan for communication among various agencies when there is a death of a person 24 years of age or younger due to suicide. “SB 561 provided a very important framework for our coalition,” said Abbie McClung of KBBH. “The Oregon Health Authority wants us to create a plan to manage our suicide prevention, intervention and postvention efforts across the county. “Postvention is how a community responds to a death, where you do safe messaging and appropriately honor the memory of that person. But there are best practices to prevent contagion, meaning preventing others who may be thinking about suicide and may follow the same path or method.” Talk openly to your kids On another front, the group encourages parents to talk with their children openly about suicide and the warning signs. And it starts in kindergarten all the way up to senior year in high school and beyond. The group papered the town with fliers in English and Spanish about the warning signs and included contacts to seek help. About 5,000 have shared the social media posts. There is also training for law enforcement, called the Crisis Intervention Team. “We’re working with local law enforcement and the Oregon State Police to train them on how to recognize a mentally ill person, or suicidal person, and diffuse the situation. It takes about 40 hours to run through the course, so it’s quite a commitment,” Ware said. You Matter to Klamath meets monthly as a whole, but in between, the various subcommittees are meeting weekly to work on their specific outreach goals. It is hoped that the forum will be a breakthrough for Klamath Falls to raise awareness and that the attempts and numbers begin to drop dramatically.
H&N photo by Tess Novotny
Motivational speaker Rebecca Kordecki talks about her rocky childhood and experiences with addiction and suicide at a town hall hosted by You Matter to Klamath Saturday, May 18.
Supporting survival:
Suicide prevention strategies
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By TESS NOVOTNY: H&N Staff Reporter
arents, friends and young folks gathered in the Mills Elementary auditorium May 18, discussing ways to prevent suicide as individuals and members of the wider community.
At least 100 people turned out for the event hosted by You Matter to Klamath, a new community organization partnership trying to address Klamath County’s high rate of suicide. It included a talk from keynote speaker Rebecca Kordecki and a presentation from volunteers with Youth Rising, a local nonprofit supporting youth. Kordecki, a motivational speaker and celeb-
rity physical trainer, said she fell into working on mental health and suicide awareness because of her own experiences with instability, addiction and suicide as a child. Kordecki was in foster care until she was 12, then lived with an adopted family for four years until she was 16. Kordecki then moved back in with her mother in California, who she said was dysfunctional.
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One day, Kordecki came home to find her mother unconscious after a suicide attempt. Her mom recovered, but soon after, as a junior in high school, Kordecki moved out on her own and got a job to support herself. “I had that very dysfunctional and not as traditional childhood — I had a lot of pain, anger and abandonment issues,” she told the Herald and News. Kordecki fell into hardcore drug addiction at 18. Her addiction spiraled for eight years, through violence and jail-time, before hitting rock bottom at 26. “I had been using so long and so hard that I realized I needed to change my life,” Kordecki said. Kordecki then sobered up in rehab, and turned to extreme physical fitness as a coping mechanism. “I became obsessed, like, the opposite of drugs, became everything was about health,” she said. “How to eat right, how to lift, how to run — I was obsessed. I was like a mad scientist.”
‘I’m trying to reach anyone who’s got stuck energy, limiting beliefs, blocks, feels heavy inside their body, or whose heart is feeling pain. The first step is making the decision to live.’ — Rebecca Kordecki, motivational speaker
Please Call for help If you or someone know is thinking about suicide, please call 911, the National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741, or call KBBH at 541-883-1030.
Mental and physical Kordecki built a successful career as a celebrity physical trainer. However, Kordecki said she came to a realization that addressing her mental health was just as important as keeping her body healthy. “I realized it didn’t matter about just having a six-pack or an eight-pack if my heart was sad and my insides didn’t feel good,” she said. “So I started doing more mindfulness work.” Since then, Kordecki has given talks and exercises on mindfulness. She uses techniques like journaling and breath work to break cycles of depression and feelings of helplessness that she said can lead to suicide. “I’m trying to reach anyone who’s got stuck energy, limiting beliefs, blocks, feels heavy inside their body, or whose heart is feeling pain,” Kordecki said. “The first step is making the decision to live.” Kordecki encouraged anyone feeling lost or close to suicide to reach out to loved ones for help, and to take the first step toward expression; maybe writing down their thoughts, practicing measured breathing or having an honest conversation with a friend. “People are caught up in their heads in loops of things they learned as a kid, or never addressed as a kid,” Kordecki said. “When I look back now, if I had these tools at 10, 11 or 12, I would have been a different person.”
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Welcome to the new (online) KBBH Website redesign expands online options for Klamath Basin Behavioral Health services
H&N Staff Report
A change desired for several years has finally taken effect, offering expanded means for the community to access services provided by Klamath Basin Behavioral Health. Officially launched in April, the newly released website, at www.kbbh.org, expands on previous services provided online, offers greater insight to what is available to Klamath County residents, and ways in which KBBH can help online or in person. It marks the first website update for KBBH since 2013, an overdue move toward a more interactive platform to help citizens of the Klamath Basin. “It is a major makeover,” said Abbie McClung, communications manager for KBBH. “We have added service descriptions, a new design, and people can now access crisis resources faster through the website than before.” Easier to navigate McClung described the new site design as a move into the 21st century, an effort toward being more visually appealing as well as making content more comprehensive and easier to navigate. The most important aspect of the re-design was an intentional priority to ensure the community is aware that KBBH offers 24 hours a day, seven days a week crisis services, and the capacity to continue to drive website users back toward that option if they are in a crisis situation and need immediate help.
Aside from the more appealing aesthetic, there are several new areas of focus added to the website not previously available with the old design. The new website includes a directory of programs and services, complete with detailed descriptions of each offering in easy-to-navigate categories. Personalized touch Also added is a section where people can virtually meet the leadership team at KBBH, adding a more personalized touch to understanding the people behind the scenes working toward better behavioral health support in southern Oregon. The site has also been redesigned to be easier to use with mobile phones and tablets. The site offers quick access to crisis resources, a directory of local, state and national behavioral health resources, career information, and perhaps most importantly – a new consumer portal. One feature of the consumer portal is a means to access myStrength – a digital behavioral health support network that provides a customized online experience specific to each user. Through the consumer portal, site visitors can also access their personal electronic behavioral health information and financial assistance. “The biggest content addition is a recategorization of the way we display our services, rather than just a list like before – now we have descriptions of each program available,” said McClung. “Programs and services categorization is the big selling point, highlighting walk-in services that are available and driving people toward imme-
diate access. Then through the consumer portal they can log into their electronic health records and access their care team.” The site’s re-design is built around a tiered drop-down menu focusing on five key areas: 24/7 help now, KBBH’s philosophy, programs and services, available resources, and a calendar coming soon. Additionally, a banner at the top of the screen provides clickable links to sub-pages highlighting walk-in services, information about KBBH, careers available via KBBH, how to contact KBBH, social media links, and access to the myStrength consumer portal. Language not a barrier Mental health services are available in Spanish by bilingual, bicultural mental health professionals. KBBH also offers a translation line with mental health services in 248 additional languages. Mental health crisis services are offered for children, adolescents, adults and entire families – available at 541-883-1030, 24-hours-a-day for anyone in immediate crisis. Those requiring immediate medical assistance should call 9-1-1. Walk-in services through KBBH are offered Monday through Friday at their offices at 2210 N. Eldorado Ave. Immediate in-person help — online or via telephone — is in place for veterans, as well as suicide prevention and intervention. Those in need of help can text HELLO to the Crisis Text Line at 741741. For more information about Klamath Basin Behavioral Health visit www.kbbh.org.
The most important aspect of the re-design was an intentional priority to ensure the community is aware that KBBH offers 24 hours a day, seven days a week crisis services, and the capacity to continue to drive website users back toward that option if they are in a crisis situation and need immediate help.
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Certified Community Behavioral Health Clinics: A Progressive Approach By ABBIE McCLUNG
Klamath Basin Behavioral Health
On June 30, 2019, Klamath Basin Behavioral Health concludes a two-year demonstration program designed to expand access to mental health and addiction care in community-based settings. Certified Community Behavioral Health Clinics (CCBHCs) were created as an eight-state initiative through the landmark 2014 legislation, the Excellence in Mental Health and Addiction Treatment Act, which represents the most significant state and federal investment in community behavioral health in over 50 years. KBBH is one of only 12 CCBHCs across Oregon providing a comprehensive range of addiction and mental health services to vulnerable individuals and meeting additional requirements related to staffing, governance, data, and quality reporting.
The collection of services offered under this demonstration stabilize people in crisis and provide the necessary treatment for those with the most serious, complex mental illnesses and substance use disorders. The service array that KBBH developed with this initiative emphasizes recovery, wellness, trauma-informed care and physicalbehavioral health integration. CCBHCs received funding designed to serve more people through an expanded workforce, improve the quality of local behavioral health services, and utilize evidence-based practices on a more consistent basis. KBBH adhered to the following federal criteria requiring nine types of services, with an emphasis on the provision of 24-hour crisis care, utilization of evidence-based practices, care coordination, and integration with physical health care. The successful outcome data can be used to support future changes to the way behavioral health services are funded and administered in the United States.
nine serviCe types provided by CCbhCs
crisis mental health and addiction services screening, assessment and diagnosis, including risk assessment
person and family-centered treatment planning direct provision of outpatient mental health and substance use services outpatient primary care screening and monitoring of key health indicators and health risk
targeted case management psychiatric rehabilitation services
peer support and counselor services and family supports intensive, community-based mental health care for members of the armed forces and veterans, particularly those in rural areas
Then and now: 2013-2019 Klamath Basin Behavioral Health has seen significant growth since 2013 when it became the Community Mental Health Provider for children and adults in Klamath County. This growth is also a reflection of a two-year demonstration period KBBH participated in as a Certified Community Behavioral Health Clinic. Number of employees: 50 220 Number of programs: 9 32 Number of facilities: 1 4 Number of consumers served:o 5,000 8,000
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Klamath Basin Behavioral Health: April 2017 through March 2018
Certified Community Behavioral Health Clinic outcomes
What’s next in Klamath County
CCBHC survey results from the National Council on Behavioral Health have demonstrated that when community behavioral health clinics are incentivized to provide evidence-based care and provided compensation that adequately covers their cost of doing business through enhanced Medicaid reimbursement, they can transform access to care in their communities. These results have proven true in Klamath County and KBBH successes include increased access to mental health and addiction treatment; expanding capacity to address the opioid crisis; collaborating with partners in hospitals, jails, prisons and schools; and attracting and retaining qualified staff who offer science-based, traumainformed services. CCBHCs serve any individual in need of care, regardless of ability to pay, thereby improving access to behavioral health services and decreasing stigma associated with mental illness. Initial outcomes from the CCBHC demonstration period have generated strong support for continuation of the project, as well as extending it to include additional states. The Oregon Legislature is in the process of considering various options for continuing the project, and Congress will be voting on a bill to extend and expand CCBHCs this fall. Looking toward the future, CEO of KBBH Stan Gilbert said, “The CCBHC project is the most significant improvement in delivery of community mental health services in many years, and is proving to be the direction the country should be taking to modernize and improve this system of care.”
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FosterPlus.org FosterPlus.org FosterPlus.org
It’s It’s not not forever, forever, but but it it can can make make their their forever forever better better
Foster Plus surrounds foster families Foster Foster Plus Plus surrounds surrounds foster foster families families with extra support, every step of the way. with extra with extra support, support, every every step step of of the the way. way. Foster Plus Informational Meeting Foster Plus Informational Meeting Foster Plus Informational Meeting Monday, May 20, 2019 at 5:30 pm Monday, 20, 2019 at 5:30 pm Klamath May Basin Behavioral Health Monday, May 20, 2019 at 5:30 pm 2210 N Eldorado Ave 2210 N Eldorado Ave 2210 Falls, N Eldorado Ave Klamath Oregon 97601 Klamath Falls, Oregon Klamath541.883.1030 Falls, Oregon 97601 97601 541.883.1030 541.883.1030