Summer 2022: Confronting our Mental Health Crisis by NYS Association of Counties

NYSAC News NEW

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SUMMER 2022

Confronting our Mental Health Crisis

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President's Page NYSAC OFFICERS Hon. Martha C. Sauerbrey Tioga County President Hon. Marcus Molinaro Dutchess County President-Elect Michael E. Zurlo Clinton County First Vice President Hon. Daniel P. McCoy Albany County Second Vice President Hon. John F. Marren Ontario County Immediate Past President

BOARD MEMBERS Hon. Luis A. Alvarez, Sullivan County Hon. Steven Bellone, Suffolk County Hon. Benjamin Boykin II Westchester County Mr. Philip R. Church, Oswego County Hon. Eric L. Adams, New York City Mr. Richard R. House, Wayne County Hon. Beth A. Hunt, Hamilton County Hon. Margaret M. Kennedy, Otsego County Hon. Mark C. Poloncarz, Erie County Dr. Kevin Watkins, Cattaraugus County

PARLIAMENTARIANS

hen work started on this issue of NYSAC News, our goal was to shine a light on the growing mental health crises in our community. Challenges from opioid and alcohol addiction, isolation and loneliness resulting from the pandemic, uncertain economic conditions, the impact of remote learning on our school children, cyberbullying and increased incidents of suicide have only grown worse in recent years. Just as we did with the COVID-19 pandemic, counties are leading the charge in addressing these crises with innovative new programs and services. We wanted to bring some of these issues and efforts to light in this edition and showcase the mental health functions we perform to help our residents through difficult times in their lives.

We acknowledge and appreciate all the first responders, the doctors, the nurses, and the many community residents who provided assistance during these tragedies. This issue of NYSAC News is dedicated to the memory of those we lost, the families and survivors who are left to mourn and grieve and pick up the pieces, and the mental health professionals who give so much of themselves in service to those in need.

Marte Sauerbrey NYSAC President

In recent weeks, however, unspeakable horrors have unfolded in our state and across our nation that will undoubtedly have a lasting and dramatic impact on the mental health needs of our communities. I’m speaking, of course, of the mass shootings that have ravaged our nation and our beloved city of Buffalo in Erie County. There simply are no words to adequately describe the mix of sorrow, anger, and fear one feels in the immediate aftermath of events like these. However, we as county officials are blessed to be in a position where we can turn that sorrow and anger into resolve. Resolve to do what we can to keep our communities safe and to ensure that our students, teachers, and residents of all stripes have access to the mental health services that they need to cope in the aftermath of these tragedies.

Hon. Herman Geist, Esq., Westchester County Hon. A. Douglas Berwanger, Wyoming County

NYSAC News | www.nysac.org

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Director's Note NYSAC STAFF (partial listing) Stephen J. Acquario, Esq. Executive Director Karen Catalfamo Office/Financial Manager Patrick Cummings, Esq. Counsel Jackie Dederick Records Manager Patricia Gettings Assistant to the Director

s I write this, it has been one month since a gunman senselessly injured three and took the lives of 10 fellow New Yorkers in Buffalo. It has been three weeks since another took the lives of 19 third and fourth graders and two teachers in Uvalde, Texas. I pray that by the time you read this, there haven’t been more. In response to these unspeakable tragedies, New York’s counties are once again stepping up to the plate to care for the emotional wellbeing of our residents. That work builds on the already significant challenges that many of our communities are dealing with, and which are the focus of this issue.

As the association representing New York’s counties, we are working in close collaboration with our members and with state leaders as they respond to these challenges and work to prevent future tragedies from occurring. There will undoubtedly be many challenging days ahead as we work to help our communities recover from the trauma of these events and put systems in place to prevent future attacks. But if the last two and half years have taught us anything, it’s that when we work together as a united force, New York’s counties can rise to meet any challenge.

Ryan Gregoire Legislative Director Alexandra LaMonte Legislative/Policy Coordinator

Stephen J. Acquario, Esq. NYSAC Executive Director

Mark LaVigne Deputy Director Dave Lucas Director of Finance & Intergovernmental Affairs Juanita Munguia Marketing Specialist Tom Oldfather Communications Manager Kate Pierce-Nimz Multimedia Specialist Grace Schneider Intern Jeanette Stanziano Director of Education & Training

NYSAC News | www.nysac.org

NYSAC News NEW

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NYSAC News NEW

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STATE

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NYSAC’s mission is to represent, educate, advocate for, and serve member counties at the federal and state levels. President Hon. Martha Sauerbrey

Editor Tom Oldfather

Publisher Stephen J. Acquario

Designer Kate Pierce-Nimz

Managing Editor Mark F. LaVigne

Advertising Staff Juanita Munguia

Cover Photo @POTUS, May 17, 2022, Twitter.

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Advertise with NYSAC Contact NYSAC Marketing Specialist Juanita Munguia at 518-465-1473 or jmunguia@nysac.org Published 3 times a year by the New York State Association of Counties (NYSAC), the NYSAC News is the official publication of NYSAC, a non-profit, municipal association serving the 57 counties of New York State and the City of New York with its five boroughs for over 90 years. NYSAC’s mission is to represent, educate, advocate for, and serve member counties at the federal and state levels.

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515 Broadway, Suite 402, Albany, New York 12207 Phone • (518) 465-1473 Fax • (518) 465-0506 Send submissions to toldfather@nysac.org. Submissions should be 750 to 1,000 words and include a high resolution photo of the author. All submissionsare subject to editing for clarity, content and/or length. The advertisements and articles in NYSAC News in no way imply support or endorsementby NYSAC for any of the products, services or messages conveyed herein. ©2022 New York State Association of Counties

NYSAC News | Summer 2022

Table of Contents Volume 44, Issue 2 Summer 2022

NYSAC UPDATE

Update on the Enacted Budget & Post-Budget Review

Affiliate Spotlight: NYS CLMHD

Top 10 Reasons to Attend the NYSAC Fall Seminar

NYSAC Finance Director Dave Lucas Honored By County Finance Officials

Putnam’s Multi-Faceted Approach to Improving Mental Health

Unseen Mental Health Struggles of Student Athletes

2022 NYSAC Photo Contest Winners

County Fairs Ready to Show What’s Great in New York State

DEVELOPING NEW SOLUTIONS

CONFRONTING NEW CHALLENGES

Counties Bolstering School Resource Officer Programs

Coping with the Unimaginable

Bringing Substance Use and Mental Health Treatment on the Road

COVID’s Impact on the Mental Health of New York’s Public Health Workforce

Changing NYC’s Mental Health Emergency Response

Restoring Common Sense to Competency Restoration

A Groundbreaking Rural Mental Health Initiative for Youth

A Devastating Gap: Supply & Demand of a Mental Health System During a Pandemic

Bringing Selfcare Directly to Your Inbox

A Natural Rx for Veterans

Mental Health First Aid Solution

Bringing Mental Health Restoration Services Where They’re Needed

A Dual Pandemic: The Public Health and Mental Health Crisis

It’s Time for Public Policy Solutions to the College Mental Health Crisis

Committed to the Community: Madison County Mental Health Task Force

Getting ‘Productively Angry’

NYSAC News | www.nysac.org

NYSAC UPDATE

Legislative Team Update on the Enacted Budget & Post-Budget Review By Ryan Gregoire, NYSAC Legislative Director

his year’s state budget was enacted in a time of historic abundance in Albany. The state had received significant inflows of aid from the federal government and personal income tax receipts – the largest revenue source for the state were 18.7 percent higher than last year's enacted state budget. Medicaid and education spending continue to be the two largest spending categories in New York. This year was no exception to that rule. In fact, Medicaid spending increased by 13.6 percent year-over-year. This program, which now totals $27.7 billion, continues to grow at an unprecedented rate—an alarming trend that we all must be cognizant of. The most significant victories for counties in the SFY 2023 State Budget can be found in the continuation of the cap on the local share of Medicaid, extension of local home rule revenue authority and our successful campaign to Keep Local Taxes Local by eliminating the diversion of sales tax to pay for the distressed hospital fund and the AIM-related payments program. Counties also saw an increase to the Community College funding floor to 100 percent of prior year funding, up from the 98 percent floor enacted in FY 2022, an expansion of broadband services and repeal of the DOT Right-of-Way Tax, and increase in Article 6 public health funding, authorization for fire departments to bill Medicaid for EMS Services, and increased funding for local Veterans’ Service Agencies and expansion of the Joseph P. Dwyer Peer-to-Peer Veterans’ Support Program statewide. For complete analysis of the county impact of the SFY 2023 State budget, visit www.nysac.org/nysbudget. The post-budget legislative session consisted of 21 legislative session days, 6 days less than last year, due primarily to the fact that this year is an election year for all 213 members of the State Legislature. Like the previous two years, the State Legislature convened in a hybrid format. Initially, the public was barred access from the Capitol and Legislative Office Building; however, the buildings

NYSAC News | Summer 2022

did re-open in March, and the post-budget period, ushering in return to semi-normal advocacy efforts. NYSAC’s advocacy work is guided by the policy resolutions which are adopted by the NYSAC standing committees twice per year, during the Legislative Conference and again at the Fall Seminar. To help communicate these priorities to legislators, staff and other key stakeholders, the NYSAC legislative team developed a brand new 2022 Legislative Program which was met with much appreciation and support from state lawmakers and county officials, and a 2022 Post-Budget Legislative Program, building off of the new design created earlier this year. Both of these documents can be viewed at www.nysac.org/advocacy. We further narrowed our focus to a few top post-budget priorities as the legislative session neared conclusion in early June, including: •

Reform of Pre-Trial Competency Restoration,

•

Permanency of County Sales Tax,

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Shared Services Reform, and

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Finalization of the ACA eFMAP Federal Pass-Thru to Counties.

Of these top priorities, NYSAC was able to secure passage of County-wide Shared Services Reform legislation (S.8887-A / A.10337-A), to make shared services proposals from previous plans eligible for state matching funds. We will continue to aggressively advocate for the remainder of these priorities in next year’s session. In addition to our top priorities, a number of pieces of legislation sought by counties were passed by both Houses of the Legislature, including: •

Financial Responsibility for Human Postexposure Rabies Treatment legislation (A.7408-A / S.7501), to require insurers to accept authorization by a county health authority as satisfying any pre-approval requirements for postexposure rabies treatment coverage,

•

Carpet Stewardship legislation (A.9279-A / S.5027-C), to require carpet producers to establish carpet collection programs, assume the responsibility and cost for collection and recycling, and prohibit the use of PFAS in carpeting, and

•

Valuation of Condominiums for Real Property Taxation Purposes legislation (A.3491-B / S.5946-B), to allow municipalities to voluntarily opt-in to value newly constructed and converted cooperative and condominium units as they would other real property to alleviate any negative impacts placed on the locality by the current statute.

In addition to these bills, NYSAC tracked, monitored, and engaged on over 2,000 pieces of legislation. In total, the Legislature introduced more than 19,000 bills (not including amendments) during this legislative cycle. This is more bills than any other state in the country. Of these bills, the Legislature passed 1,007 through both Houses, a modern-day record and slightly more than the 984 in 2021. For a deep dive into all legislation with county impact that passed through both chambers, download our 2022 New York State Legislative Session Summary at www.nysac.org/ legadvocacy.

County Conversations Podcast Tackles Timely and Pressing Issues Impacting Counties

Also available on Apple Podcasts, Google Podcasts, and Spotify Visit nysac.org/podcast to tune into NYSAC's weekly podcast series. Each episode features discussions with leaders from across the state that are focused on providing innovative solutions to local issues.

Of course, the NYSAC legislative team will continue to monitor legislation and inform members on pending legislation impacting counties. On behalf of the NYSAC legislative team, we are so grateful for your continued advocacy at the local level and here in Albany, both virtually, and in-person!

Episodes range from 20 minutes long to up to an hour long. You can listen in any order you would like, any time you like.

Learn more about all of our advocacy resources by visiting https://www.nysac.org/advocacy.

If there are any topics concerning county government that you would like to hear us discuss – or join as a guest to discuss – please email our Multimedia Specialist Kate Pierce (kpierce@nysac. org) to turn your idea into soundwaves.

Learn more about NYSAC Standing Committees

NYSAC News | www.nysac.org

Affiliate Spotlight NYS Conference of Local Mental Hygiene Directors

he New York State Conference of Local Mental Hygiene Directors (the Conference) is a statewide membership organization that has represented the Directors of Community Services (DCS)/County Mental Health Commissioners for each of New York’s 57 counties and New York City since 1976. As the CEO of their Local Governmental Unit (LGU), DCSs/ County Mental Health Commissioners oversee and manage the local mental hygiene system and develop, implement, and plan for services and supports for adults and children with mental illness, addiction, and intellectual/developmental disabilities. Cross-system coordination between and among multiple services is the primary role of the DCS/LGU. The needs of the individuals they serve are complex and extend beyond the scope of behavioral health care and into other distinct areas, such as housing, public benefits, the criminal justice system and the county jail. The role of the LGU in the local mental hygiene system varies from running direct clinic services which is especially critical in many rural areas of the State, to annual services planning to establish local priorities, needs and outcomes for the coming year. These local services plans (LSPs) are developed in collaboration with the State’s mental hygiene agencies, local providers, consumers, and other community members. The Conference itself works to further the voice and expertise of these dedicated professionals and to maintain and strengthen the roles they play in communities across New York State.

To accomplish these goals, the Conference focuses on five core values:

Collaboration Fostering partnerships with stakeholders to develop solutions.

Innovation Solving problems through being flexible, creative, and adaptable

Advocacy Promoting responsible public policy to address the needs of the people in our diverse communities.

Credibility The Conference is accountable to its members, partners, and stakeholders through their depth of knowledge, experience, and follow-through.

Quality The Conference is committed to excellence in their work. By speaking with a unified voice, the Conference advances public policy and advocates for optimal quality of life for people impacted by mental illness, addiction and/or intellectual/ developmental disabilities. To learn more about the New York State Conference of Local Mental Hygiene Directors, visit http://www.clmhd.org/.

NYSAC News | Summer 2022

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NYSAC News | www.nysac.org

Top 10 Reasons to Attend the NYSAC Fall Seminar 1. Remain informed and up to date on the rapidly changing local, state, and federal policy environment. 2. Learn how the 2023 NYS Legislative Session could impact counties and property taxpayers, which issue areas to keep an eye on, and how to advocate for your county.

8. Get the latest on innovative local approaches to public health, public safety, technology, tourism, employee engagement, and more.

3. Discuss and vote on the resolutions that direct NYSAC's advocacy efforts.

9. Meet hundreds of vendors offering high-quality solutions to the challenges counties face.

4. Hear from leading experts on the national, state, and local issues impacting counties.

10. Gain the knowledge and tools to be an even more effective public servant in your community.

5. Attend timely and informational workshops on topics of concern for counties. 6. Attend NYSAC Women's Leadership Council sponsored events for unique perspectives on issues facing women in government.

7. Network and share best practices with hundreds of dedicated and passionate county officials from across the state in a bipartisan setting, focused on the needs of our counties.

NYSAC News | Summer 2022

Stay up to date at nysac.org/fallseminar

NYSAC Finance Director Dave Lucas Honored By County Finance Officials By Tom Oldfather, NYSAC Communications Manager

he New York State County Treasurers and Finance Officers Association presented its annual President's Award to Dave Lucas, the Director of Finance and Intergovernmental Affairs for the New York State Association of Counties (NYSAC). “Dave Lucas is a great resource for all of our counties. He knows the budget process at both the state and county levels, and the intricacies of how state programs impact county budgets. He is always available to provide information, analysis, and advice for county fiscal officers,” said Nancy Buck, President of the County Treasurers Association. “I am honored and humbled to receive this recognition by the NYS Treasurers and Finance Officers Association. Managing public finance is a complex job and very important to the local taxpayers. We have seen dramatic swings in state and local finance over the past few years and it will remain a challenging environment for us all. I would like to acknowledge the important work of local finance officers as this award is given to me,” said Lucas. The President's Award was presented at the 56th annual County Finance School in Syracuse this week. The award recognizes individuals for their dedication and hard work on behalf of the association. “We are incredibly fortunate to have someone one our team with Dave's unparalleled understanding of the state budget and its impact on local governments. He can break down the state spending plan better than anyone else in the state," said NYSAC Executive Director Stephen Acquario. Dave joined NYSAC in 2010 as an expert on Medicaid and state and local fiscal issues, including the dozens of state programs that counties are mandated to implement. Prior to joining NYSAC, Dave worked as a Deputy Director of Federal Relations for the State of California in Washington, D.C., working on congressional and federal policy issues. Prior to that, he worked for the New York State Division of Budget on federal relations.

Dave Lucas, NYSAC Director of Finance and Intergovernmental Affairs and Nancy Buck , Sullivan County Treasurer and President of the NYS County Treasurers Association "His dedication, expertise and steady hand have been indispensable to our members, especially during the pandemic when counties were faced with a potential fiscal catastrophe, and have benefitted the residents of our state more than they'll ever know,” said Acquario. County Finance School is co-sponsored by the County Treasurers association, the Office of the NYS Comptroller, and the New York State Association of Counties.

NYSAC News | www.nysac.org NYSAC News | www.nysac.org

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CONFRONTING NEW CHALLENGES

Coping with the Unimaginable Erie County’s Mental Health Response to the Tragedy in Buffalo By Alexandra LaMonte, NYSAC Legislative/Policy Coordinator

n May 14th, Erie County experienced an unspeakable tragedy when a white gunman opened fire in a grocery store in one of Buffalo’s predominately Black neighborhoods, killing ten people and wounding three others in the racially motivated attack. This act of domestic terrorism left the community reeling and reopened psychological wounds for those already suffering from the physical and emotional burden of race-based traumatic stress. In the aftermath of the shooting, Erie County immediately recognized the important role the county would need to play in meeting the basic needs of those who required food and other necessities they could no longer get from the neighborhood’s only grocery store. The county also recognized the importance of getting mental health support to a community that already carried the collective trauma of racism and was retraumatized by the massacre. It was important for all those involved to create a safe space for the individuals affected by the shooting and provide culturally relevant counseling and support. Historically, many Black Americans have been reluctant to seek mental health counseling for a host of cultural, historical, and practical reasons, including the stigma around mental illness, lingering racial biases in mental health treatment, and a lack of access to services. Erie County worked to find trauma and grief counselors who looked like people they were trying to reach and enlisted the help of mental health organizations, private practices, and schools to identify diverse professionals who were willing to provide this support. The county also designated a volunteer coordinator from the County Executive’s Office to organize the community volunteer effort. Volunteers and mental health professionals were dispatched to homes to perform wellness checks, conduct mental health assessments, and deliver food. Social service workers set up in the community to connect residents with safety net services like the Home Energy Assistance Program (HEAP), which helped families to pay their bills during this difficult time. In the county offices, it was an all-hands-ondeck effort, with agencies like the Department of Homeland Security & Emergency Services and the Office of Geographic Information Services (GIS) partnering to help get information out to the public.

NYSAC News | Summer 2022

Erie County would not have been able to reach as many residents as it did if not for its strategic, years-long efforts to promote diversity in leadership and strengthen relationships between departments and with community partners. Many of the elected leaders and department heads who were onsite following the shooting were people of color, including the Chairwoman of the Legislature, Director of Health Equity, Personnel Commissioner, and Social Services Commissioner. Their presence helped extend the county’s reach to members of the predominately Black community and made residents feel more comfortable seeking out mental health support and other assistance. Additionally, the Live Well Erie initiative – launched in 2019 to improve health outcomes and quality of life for older adults, working families, and children – created a network of more than 40 community partners that the county was able to call upon to support the incident and mental health response. Live Well Erie has also helped to facilitate regular communication and build relationships between county departments that typically work in silos. These relationships allowed for more efficient and effective communication when all departments were mobilized to help those in need of services. The road to recovery and healing for the community will undoubtedly be long and painful. In the weeks and months to come, Erie County will continue its commitment to rebuilding East Buffalo in an equitable way. This means acknowledging and addressing the consequences of racist policies that have made Buffalo one of the most segregated cities in the country and an easy target for white supremacist violence. It will also require partnering with the City of Buffalo and federal government on strategic planning, emergency preparedness, and recovery efforts. By strategically investing in areas like housing, economic development, neighborhood beautification, and mental health services, Erie County hopes to create enduring change in the historically marginalized East Buffalo neighborhoods and ultimately help residents regain the sense of peace they lost in the hate-fueled attack.

NYSAC News | www.nysac.org

COVID’s Impact on the Mental Health of New York’s Public Health Workforce By Sarah Ravenhall, MHA, CHES, Executive Director, NYSACHO

he pandemic has presented historic challenges to the response capabilities of public health first responders. Already taxed by pre-pandemic workloads that extended beyond available resources, staff saw an explosion of critical tasks and responsibilities to combat and mitigate transmission of the COVID-19 virus. Not only were local public health staff subject to this tremendous increase in workload, but they also faced numerous other challenges, including daily exposure to risk of infection, worry for their own loved ones, and hostility from a public that was and remains conflicted on compliance with response activities. Such was the degree of public hostility vented toward public health staff, that intimidation and physical threats became prevalent across the state. The combination of these factors created exceedingly high levels of stress in the public health workforce, driving considerable and widespread harm to the mental health status of the field—impacts that were significantly exacerbated by chronic shortages of resources and staff resulting from years of public health disinvestment by the state and federal levels. To gauge the impact of these elements, NYSACHO worked with a consortium of researchers from SUNY Oneonta, Bassett Healthcare Network Research and Utica University to conduct a statewide survey of public health workers, the findings of which were compiled in a report entitled “Pain and Perseverance.” More than 200 staff responded to the survey, documenting the profound impact these factors have had on public health workers. As one official noted in the report: "We have lost our entire managerial staff due to retirement due to Covid. It is very difficult to navigate without institutional knowledge. Two of my co-workers had a new diagnosis of cancer which they blame on the stress of doing case investigations."

NYSAC News | Summer 2022

Specifically, the survey data indicate: • 90.4% of respondents have felt overwhelmed by workload, • 75.6% felt disconnected from family and friends because of workload, • 65% felt unappreciated at work and 75% felt inadequately compensated, • Over half of respondents reported experiencing stigma or discrimination during the crisis, • 35% received job-related threats because of work by members of the public, • 55% felt bullied or harassed because of work by the members of the public, and • 30% have received any sort of hate mail/email/messages from the public.

These findings accrue to a crisis within the ranks of the public health workforce, triggering a significant exodus from the field by many workers and leaders that has further worsened staff and resources shortages. Moreover, the survey findings make clear that the public health infrastructure has reached a tipping point. To stabilize the public health system and protect and retain the dedicated workers employed by local health departments, investments need to be made to Article 6 state aid funding to ensure that these public health entities are appropriately staffed and thus able to allow employees to manage worklife balance and avoid burnout. Making such investments will protect and ensure longevity in the state’s public health workforce. This year’s State Budget included new investments in Article 6 funding that are welcomed but must not mark the end of New York’s investment in an overburdened system. As New York State Commissioner of Health Dr. Mary Bassett said in recent interview, “Overcoming years of underinvestment in public health won’t be a one-shot deal.” In addition, counties will be challenged to recruit, retain and employ new public health professionals entering the field, of which, many are drawn to the private for-profit sector and health care systems for work. Experienced and trained workers will need to replace those who have retired or departed from local health departments due to stressors related to their jobs during the pandemic. Federal and state lawmakers can support localities' ability to hire by increasing infrastructure funding, passing policies that support tuition reimbursement, expanding benefits for local health department workers and promoting the important work that governmental public health workers lead in their communities. The broad scope of public health threats to our communities coupled with the deleterious impact of underinvestment on the capabilities and mental health status of our public health workforce demand continued vigilance and continual investment by the state. NYSACHO will continue to fight for these resources, and we are grateful for the strong support we have received from NYSAC and many other partnering organizations. To read the full report, visit the Intermountain COVID-19 Impact Consortium website, and click on “Publications”: https://suny.oneonta.edu/places-institute/covid-consortium. Thank you to the hard-working partners from the ICIC for their leadership and contributions to this study and report.

NYSAC News | www.nysac.org

Restoring Common Sense to Competency Restoration By Jed Wolkenbreit, Counsel, NYS Conference of Local Mental Hygiene Directors

s tragic stories of people with mental illness being harmed or killed during interactions with law enforcement continue to appear in New York and around the nation, it begs the question: “How could we better serve mentally disabled criminal defendants?” In the 1840’s New York began to institutionalize the mentally ill in state institutions at county expense. Counties often chose to retain these mentally ill people in the community by committing them to poorhouses or jails. Over time, the funding of state hospitals became solely a state responsibility, and these institutions became the main depository of the mentally ill until advances in pharmacology and the cost of institutional care started a movement to return mentally ill patients back into the community. Unfortunately, the lack of real discharge planning or a funding source led to major increases in homelessness and increased contact with the criminal justice system—a de facto return to the poorhouses (homeless shelters) and jails of the nineteenth century. This trend required the criminal justice system to face the issue of how to handle a mentally ill person who was incompetent to stand trial (IST). The US Supreme Court, in Dusky v. US, held that to be competent to stand trial, a defendant must have sufficient ability to rationally consult with his lawyer and a rational and factual understanding of the proceedings. IST defendants are therefore sent to a state institution to receive services that are intended to restore that defendant to competency and allow the trial to proceed. Restoration services may include some traditional treatment elements such as providing medications but mainly include classroom training as to how to act in court and how to answer questions asked by the judge to establish ability to stand trial. Mental health treatment leads to recovery, restoration leads to trial in a courtroom.

NYSAC News | Summer 2022

The State Mental Hygiene Law has long provided that the cost of these services are chargeable to the county in which the court that issued the order for restoration is located. Until 2020 the State only passed on half of the cost of these services. In 2020, it began charging the full charge of approximately $1000 a day for restoration services. This change was a wakeup call for many counties who began receiving bills of hundreds of thousands or even millions of dollars. Also, despite the Supreme Court ruling in the case of Jackson v. Indiana that states may not indefinitely confine criminal defendants solely on the basis of incompetence to stand trial and that the commitment duration be limited based on the likelihood of restorability, we are still seeing defendants with low IQs, traumatic brain injury or terminal dementia spending 3, 5 or up to 10 years in “restoration.” Neither the psychiatric examiners nor the court ever consider whether there is any reasonable likelihood that the defendant can be restored. Furthermore, and most importantly, the determination of incompetency makes the defendant unable to legally plead to any charge which is a requisite for being diverted into a mental health court program which might actually help them reach recovery. To begin to address this issue, NYSAC and the NYS Conference of Local Mental Hygiene Directors have worked together to develop legislation to amend section 730 of the criminal procedure law to help make it more rational. This legislation, (A 8402-A) Gunther/ (S7461) Brouk, would make significant improvements to the current competency restoration process by creating a clear definition of restoration services, requiring improved progress reporting, creating new regulations, and allowing the Court rather than the DA to decide if a person can be sent for restoration services in the community rather than in a state facility, among several other provisions.

In addition to the passage of this legislation, costs to counties could be substantially reduced if restoration services are properly deployed and rigorously monitored. Many judges (especially local court judges and justices) truly believe that they are helping a defendant to get mental health treatment by ordering restoration but this is simply not the case; restoration is not recovery. In fact, by ordering restoration in those jurisdictions which have a mental health court, the defendant is precluded from being diverted to treatment because in order to participate in mental health court, they have to plead guilty and if they are not competent, they cannot plead. Secondly, even when restoration is appropriate, it can be done locally on an outpatient basis with the approval of the local DA but most, if not all DAs refuse to give such consent. Finally, defense attorneys often believe they are doing the right thing by their clients by having them sent to a forensic hospital as it is likely a better place than a jail or prison, but they would be much better off if they could be diverted to real mental health treatment aimed at recovery rather than services which are solely directed to the ability to participate in the criminal justice system.

It is imperative that County Executives, Managers and Administrators; local legislators, judges, DAs, Public Defenders and County Probation start to have real conversations with each other about this problem. County budgets can be reduced by sending fewer people to state restoration. Moving the cost of restoration to the DAs budget may make the DA more amenable to allowing outpatient restoration which may be eligible for Medicaid subsidy in appropriate cases. Educating judges and public defenders about what constitutes mental health treatment and what restoration accomplishes, explaining other options for them to get information about the defendant’s mental status without ordering restoration and helping to make better use of diversion or even to create or make better use of mental health courts are all possibilities. Where available, courts could use its powers under MHL §9.43 and the services of local probation departments for pre-plea reporting to accomplish diversions as appropriate. All these are avenues that can be explored and which can help create a win-win situation for all parties. There is a fix for the system if we all do our part.

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NYSAC News | www.nysac.org

A Devastating Gap Supply & Demand of a Mental Health System During a Pandemic By Brian Hart, LCSW-R, Commissioner Chemung County Departments of Social Services and Mental Hygiene

hile this story is not unique in many ways, the experience in Chemung County is worth sharing if for no other reason than to help those outside of the healthcare delivery system appreciate the strains on the mental health system. Some may describe what has happened as a perfect storm, others as a failure of the system. In recent years, the components leading up to our current times include a plan to reduce state operated mental health beds without replacing them with private sector beds, bail reform allowing virtually nobody to be placed in jail, but to be given an appearance ticket instead, and an epidemic of drug overdoses and fatalities all nicely wrapped up by a worldwide pandemic. The aftermath of which has yet to be fully revealed, but they collectively have resulted in many homeless individuals with chronic mental illness living, at best, in a motel. Our mental health system has, in essence, been converted into a pressure cooker with no relief in sight, as being hospitalized has become an exception. There is next to no movement in the mental health housing system as affordable housing has become a misnomer. This is especially true for counties along the NYS PA border left with astronomically high rents following the gas drilling surge. As the pandemic devastated so many, the perspective of working from the office has led to a national virtual work force in many situations, and unprecedented vacancies rates in others. Nobody predicted that universally all sectors of healthcare, retail, and manufacturing alike would be left with a significant workforce shortage. For the mental health system, this has meant limited to no access to services concurrent with a society struggling with an emotional backlash of epidemic proportions in and of itself. Demand for mental health services is higher than it has ever been, and staff to provide such is at what appears to be the lowest in modern history. In Chemung County one would therefore expect a system of total chaos, but the real story is slightly brighter than one may expect, as our community has always been one of resilience despite a history of being at the top of many of the wrong lists.

NYSAC News | Summer 2022

Completed suicides amongst adults and youth alike have remained stable since 2015. We have been successful in maintaining either virtual or in-person counseling for nearly 3,000 individuals a month through our licensed mental health clinics including nearly 300 youth a month in our school-based clinic service. As a community we have provided, and continue to provide Narcan education. This community approach to education along with many collaborative efforts introduced by the Substance Abuse Regional Alliance have been a jump start to addressing this issue. Our efforts include a FREE phone application (SARA.partners), and publicly accessible commercials. The net result has been a 30% decrease in opioid reversals since 2017 and maintaining such even during the COVID outbreak. I wish that all of our efforts yielded positive systemic changes, but we still find ourselves with long waiting lists for mental health counseling at local agencies and private practice offices. Our long-time homeless housing provider is opting to stop providing this service primarily because of the intensified need of these seeking this service, despite us having nearly 200 individuals homeless during the winter months. Most individuals brought to the hospital for mental health acute care, are assessed and turned away for not meeting medical necessity. With a commitment to continue addressing the gaps while simultaneously enhancing our quality of services, Chemung County has initiated law enforcement online trainings offered by the Disaster Technical Assistance Center. A pilot sponsored by the NYS Office of Mental Health is providing iPads to law enforcement allowing direct connectivity with our mobile crisis team, and we have been approved to engage stakeholders in the Sequential Intercept Model of addressing needs. In 2022, a mental health licensed Family Center will open up with a focus on Trauma Informed Care practices, and one of our providers will also be expanding their substance abuse clinic services to include methadone treatment. In another words, as nearly 2,500 individuals note in our flower garden during the annual suicide prevention walk, there is “HOPE” for our resilient community as well as yours!

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NYSAC News | Summer 2022

Bringing Mental Health Restoration Services Where They’re Needed By Amber H. Simpler, PhD, ABPP, Board Certified in Forensic Psychology, Chief Psychologist, NaphCare

ew York is on the verge of passing legislation that will allow it to join a dozen other states across the country and begin providing jail-based restoration (JBR) mental health services for county correctional defendants who have been found unfit to stand trial and are in need of competency restoration services, rather than providing those services exclusively through state mental hospitals. By permitting some patients to receive care in the jail setting, we can more quickly intervene to help patients who are in mental health crisis, reduce human suffering, and provide more cost-effective services while saving money for taxpayers. The result is a win for the patients who need competency restoration services, a win for Sheriff ’s offices, and a win for taxpayers. The need for JBR arose, in part, from the fact that counties previously shouldered only 50 percent of the costs of sending mentally incompetent defendants to state psychiatric facilities, with the state covering the other 50 percent. That formula was changed so counties now bear the entire cost of competency restoration expenses. JBR is a way for counties to improve patient outcomes by reducing lengths of stay and delays related to transfer from county to state facilities while also allowing incarcerated individuals to stay in communities closer to family and personal networks while receiving restoration services. JBR has also been shown to significantly reduce costs to the county.    Legislation was introduced (A.7061/S.9133) by Senator Mannion and Assemblymember McDonald, respectively, that would amend the criminal procedure law, to establish a five-county, three-year pilot JBR program. The optional pilot would permit county jails to operate jail-based competency restoration services for inmates deemed unfit for trial due to an active mental illness or an intellectual disability. JBR would allow for faster initiation of restoration services (i.e., avoiding delays in transferring to state facilities), thereby reducing the amount of time individuals are waiting to begin services and minimizing delays in due process.

When an individual is deemed incompetent to stand a trial, they must be restored to competency before the legal process can continue. Under New York State’s current system, competency restoration for a defendant is provided either at an outpatient restoration program or a state psychiatric facility. Most of the time in New York, the defendant is remanded to a state hospital. Providing counties a third option, jail-based restoration, could allow most of these individuals to be restored in their own communities and not sent to a state hospital—a level of care most would not require or be eligible for outside of the criminal commitment. Serving inmates at the local county jail greatly helps their mental health by allowing the individual to remain in their community and close with their community connections. Data has shown decreased rates of recidivism and increased psychiatric stability for individuals allowed to remain near those who can offer social support compared to inmates shuttled to entirely different parts of the state, away from their family, friends, and support system. Many criminal justice reform groups and correction experts support JBR as an additional resource along the care continuum because it allows for quicker access to services and subsequent stabilization of psychiatric symptoms at a pivotal time in their life. Having the option of providing some of these services in the jail setting will be tremendously beneficial. Patients who are appropriate for transfer to a state mental hospital for mental health care and competency restoration will still be transferred to such a facility as appropriate and as beds are available. In this year’s legislative session, we have had the support of a number of legislators and policymakers in both chambers and among professional staff. The Governor's Office has expressed support for the legislation as well, as OMH has previously supported JBR. It is critical for counties to voice their support and let their county legislative delegation know it's critical to pass this much needed legislation. NYSAC News | www.nysac.org

A Dual Pandemic The Public Health and Mental Health Crisis By Sara Boerenko, LCSW, Public Health Director, Montgomery County

rior to March 2020, the nation was in the midst of a mental health and opiate crisis. There was a lack of providers, a lack of program staff, and high rates of suicide and overdose in the United States. Going forward through the COVID-19 pandemic, suicide and overdose did not stop. The workforce crisis and shortage of providers grew. In Montgomery County, we saw an increase in the need for behavioral health services, access to care and community-based services to meet people “where they are at.”

and community-based organizations that were getting back to home visits.

As a dual department, we were able to integrate COVID work with behavioral health work. Our staff, while making daily quarantine/isolation calls to patients, also inquired about how patients were doing mentally. Staff asked patients how they were feeling, talked to them about the fears they had and how they were taking care of their own mental health. Often the stress of isolation was due to not being able to work, not being able to see family and loved ones; fears related to obtaining basic needs such as food, milk, diapers, baby formula.

Our teams also continued to host and train the community on Mental Health First Aid. A typical class of 25 participants was cut down to 10; however, we held five classes at capacity and welcomed 50 new mental health first aiders to our county. We also took calls from community members that who had lost family and were looking for a friendly voice to talk to as a way to combat the loneliness and isolation they were feeling.

We helped connect our patients with crisis hotline numbers and food pantries that made home deliveries, worked with our legislator to arrange Meals on Wheels to drop food to elderly, and assisted with getting families basic needs to alleviate the mental stress of isolation. Upon opening the county in a safe manner, we immediately began hosting small Narcan trainings for our community. We held five trainings, limiting the groups to seven people, spaced out, and under 20 minutes. By doing this, over the course of four months, we trained 34 new people on opiate overdose response procedures. We also met with community members one-on-one to provide individual trainings. In all, we had 47 new community members trained on how to use Narcan. Further, in our down time, we assembled and delivered over 500 opiate overdose response bags to local volunteer fire departments, our police departments, ambulance services, 26

NYSAC News | Summer 2022

Since social media was used so much to disseminate information, we ran weekly mental health and substance use campaigns offering messages of hope to our community. Our largest ad campaign ran for three months and advertised the local HELPLINE number with a message: “The Link: substance use – overdose – suicide.”

Staff in our department offered phone calls to those needing support. A few community members did ask to see us in person. When it was possible and safe, I did allow a few (four) community members to come to our department to meet with me to discuss how they were struggling with various aspects of this new normal. One of the people I met with still calls me every so often to say hello and sent our department a beautiful Christmas card. There are endless stories of what the Montgomery County Public Health and Mental Health Departments did during the pandemic on top of the workload of managing the actual pandemic. But the hard work, the heavy lifting starts now. We see the damage done as a result of services halting for two years and we need to get back to overall health and wellness. We learned that for the next pandemic, we are better prepared to assist with a holistic approach to our community. We know how to provide behavioral health services in conjunction with emergency preparedness measures to ensure wellness.

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It’s Time for Public Policy Solutions to the College Mental Health Crisis By John Richter, MPA, Director of Public Policy, Mental Health Association in New York State

vidence of a growing mental health crisis on college campuses has been accumulating for nearly two decades and has undoubtedly been made worse by the COVID pandemic. Despite periodic media attention to this trend, until very recently, lawmakers have not offered legislative solutions and seem inexplicably unaware that a problem even exists. The Mental Health Association in New York State, Inc. (MHANYS) has launched a campaign to bring awareness to the crisis and to encourage public policy solutions here in New York. Some of the first indicators that a crisis was brewing are found in a Healthy Minds Study (HMS) that gathered student mental health and utilization data annually between 2007 and 2017. The large internet-based survey of 155,026 students from 196 U.S. colleges and universities revealed some startling trends in prevalence and treatment-seeking behavior. For example: •

The proportion of students with a diagnosed mental health condition increased from 21.9% in 2007 to 35.5% in 2017,

•

Rates of depression increased from 24.8% in 2009 to 29.9% in 2017, and

•

Rates of suicidal ideation went up from 5.8% in 2007 to 10.8% in 2017.

During the same time frame there was a significant uptick in students seeking mental health treatment, which either reinforces the prevalence data (i.e., more students with symptoms) or reflects shifting attitudes about mental health (reduced stigma)—or both. The COVID-19 pandemic has only made matters worse for college students, contributing to an added measurable spike in anxiety, depression, and suicide among college students. The

NYSAC News | Summer 2022

pandemic introduced a level of fear, uncertainty, and isolation so profound that its impact has increased the incidence of moderate to severe anxiety and depression among first-year college students by 40% and 48% respectively. The pandemic has without a doubt contributed to a perfect storm of mental health challenges on college campuses and some lawmakers in New York are paying attention. In 2018, Disability Rights Advocates brought a class-action lawsuit against Stanford University on behalf of three students at the University alleging that the University repeatedly violated state and federal anti-discrimination laws in its response to students with mental health disabilities, including those who have been hospitalized for self-harm and suicide attempts. Central to the lawsuit was Stanford's involuntary leave of absence policy and procedures which were characterized in the suit as punitive and onerous. The lawsuit ended in a settlement wherein Stanford, without an admission of liability, agreed to revise its involuntary leave of absence policy, ensure sufficient staffing to support students with mental health disabilities, and increase training for anyone involved with implementing the policy. The University also agreed to pay the plaintiffs' legal fees which amounted to nearly half a million dollars. The Stanford University lawsuit underscores a lack of parity between physical illnesses and mental illnesses in many college leaves of absence policies. But despite attention to the escalating mental health trends in colleges and universities through exposure in the media and the Stanford University lawsuit, there is an astonishing scarcity in legislative response at both the national and state level.

Fortunately, here in New York, that’s beginning to change. Legislation introduced by Senator Anna Kaplan and Assemblywoman Aileen Gunther (S.7659/ A.9753-A), includes provisions to increase mental health literacy, require the review of college student leave of absence policies and create more telehealth/virtual counseling opportunities within the State University system.

whole health parity. That’s why MHANYS supports S.7659/ A.9753-A, which addresses both of these needs on SUNY and CUNY campuses. MHANYS supports similar provisions in the law that would apply to independent and private colleges and universities. For more information about MHANYS College Mental Health campaign please contact John Richter, Director of Public Policy, MHANYS at 518-434-0439, or at jrichter@mhanys.org.

MHANYS has launched a campaign to draw more attention to the college mental health crisis and is calling for a summit of higher education and mental health stakeholders, and state lawmakers to help shape a public policy response to the crisis here in New York. MHANYS released a white paper, Mental Health & Higher Education in New York: A Call for a Public Policy Response, in February 2022 to raise awareness about the crisis and to call for a public policy response. The summit is planned for the fall 2022. As part of its campaign, MHANYS is promoting public policies to increase mental health literacy on campuses and encourage

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NYSAC News | www.nysac.org

Putnam’s Multi-Faceted Approach to Improving Mental Health By Michael Piazza, Commissioner, Putnam County Department of Social Service and Mental Health, and Michael Cunningham, Director, Putnam County Office for Senior Resources

he COVID pandemic has tipped the scales causing a tsunami of mental health concerns. This is as true in Putnam County as it is around the state and the globe. Access to services has been hindered and mental health needs have increased. In Putnam, these challenges converge on two pre-pandemic issues: the opioid use epidemic, and a growing population of older residents living independently with varying needs. Fortunately, in a county of just under 100,000 residents, collaboration between the government departments of Social Services and Mental Health, Public Health, and the Office for Senior Resources dates back decades. With serious traction gained over the past two years, Putnam County leadership and community organizations are implementing multi-faceted solutions spanning the age spectrum.

Solving the burgeoning mental health crisis is facilitated by local recognition that mental health is public health, and that responding to crises through the lens of mental health is foundational. The local health department is expanding the capabilities of Putnam County’s Medical Reserve Corps. These volunteers are learning to respond to mental health and substance use aspects of public health emergencies, including naloxone usage for harm reduction and suicide prevention. Putnam’s Prevention Council, a local non-profit, has been a key driver of the expansion of naloxone training and availability. Youth have been particularly affected by the pandemic. To support this population, the Department of Social Services and Mental Health has been shepherding a project with CoveCare, one of the largest mental health care providers in the county. Now in the final stages, school-based services are set to begin. Pre-pandemic, two school districts had requested onsite services; now four more are interested, along with Green Chimneys, a non-profit providing residential education for students with special needs. With a $25,000 grant, CoveCare is working with the Putnam Valley School District to establish a satellite clinic in one of their schools. Here face-to-face services will be provided on school grounds, reducing the need for telehealth which has been less effective for some individuals. For families, these school-located services can eliminate a constellation of other stresses.

NYSAC News | Summer 2022

Seniors are another focal point for Putnam’s efforts. Keeping seniors physically active is crucial to preserving and enhancing their overall well-being. During the 14-month closure due to COVID, many services continued; others were enhanced to combat seniors’ heightened sense of isolation. Reopened in May 2021, Putnam’s Office for Senior Resources (OSR) has further expanded in-person activities. A primary target of the Older Americans Act, nutrition is a critical component for a healthy lifestyle. OSR serves daily hot, nutritious noontime meals as well as providing home delivered meals for those that are homebound, a service that expanded significantly during the pandemic. Evidenced-based interventions (EBIs) offered to reduce falls and fall risks include “A Matter of Balance” and “Tai Chi for Arthritis,” both available with OSR for nearly a decade. “Bingocize,” considered an EBI by the Administration for Community Living (ACL), is the newest addition. More than 80 classes, at four strategically located senior friendship centers and remotely, are held each week. Programs offer opportunities for socialization and companionship, nutrition education and health screenings, and include a wide variety from chair Yoga and chair Zumba, to brain fitness and water bottle exercises.

Other programs include virtual or in-person wellness checks, transportation to appointments, social model day services for functionally impaired seniors and Putnam SeniorCorps offering meaningful volunteer experiences throughout Putnam County. A more sustainable future in post-pandemic Putnam also rests in two plans to increase access to services. Long championed by the Department of Social Services and Mental Health, the county’s first crisis stabilization center, which will employ a supportive-care model with available funds from the American Rescue Plan Act, is in the initial planning phase. Meanwhile, OSR is collaborating with four other Mid-Hudson counties— Dutchess, Rockland, Orange and Ulster—on the development of a regional, health network to effect better quality of life and health outcomes for older residents and their caregivers. The network would promote services that impact social determinants of health to support seniors living as independently and as healthily as possible. Community-based programming specifically tailored to the community needs is the essence of public health. The promise of this collaborative work, addressing the social factors that determine one’s health, has the potential to transform health outcomes for those in need and the possibility to elevate the health landscape for all.

NYSAC News | www.nysac.org

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NYSAC News | Summer 2022

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Unseen Mental Health Struggles of Student Athletes By Sophia Goss, NYSAC Intern

n examining the demographics of your county, which teenagers would be the primary focus of allocating mental health resources to? The kids who never show up to school? Perhaps the individuals who are frequent detention-goers? But what about the star athlete with a 4.0 GPA? If this teenager wasn’t on your list I do not blame you. As the students that are often expected to be leaders, and are looked to by administration to set an example for the rest of the school, it comes as no shock that the mental health needs of student athletes are often pushed to the back burner. The unfortunate reality is that student athletes are some of the most susceptible to struggling with mental health. According to the Clay Center for Young Healthy Minds, about 73% of student athletes suffer from anxiety, depression, eating disorders, or substance abuse. The immense pressure that student athletes feel to be perfect in every facet of life is staggering. For me, playing on a State Championship winning volleyball team while taking four AP classes my senior year was far more challenging than I had ever anticipated. Thankfully, I am fortunate enough to have an incredible support system through my family, school, and team. But I am not naive, and recognize that many of my peers are not afforded this same luxury. Schools across the state have always put an emphasis on the fact that we are students before we are athletes; before we’re anything, for that matter. But of course, that is not the case; above all, we are human beings, and we struggle as much as, or more than, any other person. The difference is that, due to the way student athletes are perceived, many feel as though they do not have anywhere to turn when life becomes overwhelming.

Fear and shame and the stigma surrounding mental health too often win out - and the results sometimes turn deadly. Media accounts of up-and-coming young athletes that have taken their own lives due to the pressures they feel from school and athletics are distressingly commonplace. The notion that it is selfish to take time to check in with yourself and your mental wellbeing is still incredibly prevalent amongst young people, especially when you feel as though you have a team, family, or community that you are letting down in doing so. So what can you do about it? It is easy to feel helpless in this circumstance, empathizing with teenagers is typically no small feat, but it is important to make sure that the student athletes in your counties have your support. Make it a priority to ensure psychologists and social workers are at the disposal of anyone who needs a listening ear, or perhaps you can go to a few games, matches, or meets every season, and commend the athletes on a job well done. It is time that schools, counties, and New York State take a proactive approach to this critical issue. I can guarantee you that this is not a problem that will dissipate on its own, and until it is addressed, student athletes will continue to suffer in silence. It is a daunting task, there is no question about it, but I am certain that it will be easier to tackle this problem head on, rather than wait to read about another bright, talented young person who has taken their own life.

NYSAC News | www.nysac.org

2022 NYSAC Photo Contest Winners

Breakneck Ridge

Congratulations to each photographer for capturing these beautiful shots in NY counties. All 62 counties in the state are full of gorgeous scenery and rich history, and NYSAC is proud to highlight them. Be sure to look for these photos in the 2023 NYSAC Calendar, available at the upcoming NYSAC Fall Seminar! Mohonk Preserve Testimonial Gateway

Photographer: Skip Pearlman

Local fishing spot in Granville

Ulster County

Washington County

Photographer: Kyle Bourdon

Photographer: Lauren Whiting

Fall afternoon at High Falls Titus Mountain

Putnam County

Morning along the Hudson River Trail

Franklin County

Saratoga County

Photographer: Derek White

Photographer: Susan Meyer

NYSAC News | Summer 2022

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County Fairs Ready to Show What’s Great in New York State By Grace Schneider, NYSAC Intern

ith warm summer days approaching, many county fairgrounds are preparing to reopen, some for the first time in 2-3 years. The excitement surrounding the return of county fairs shines through in the electronic countdowns featured on so many fair websites, even as they are 90-100 days before opening day celebrations. Details on each fair can be found in a directory provided by the Department of Agriculture and Markets at newyorkstateyouthandagriculturalfairsdirectory.pdf (ny.gov). There you’ll find information about featured performers like Tracy Byrd who will be performing at the Oneida County and Franklin County Fairs, as well as learn about exciting themes like Essex County’s “Hawaiian Luau” and Herkimer County’s “from Wagon Wheels to Ferris Wheels.” In addition to local county fairs, the Great New York State Fair is also set to return this year from August 24th to September 5th. More information, including performance announcements, can be found on the New York State Fair website at www. nysfair.ny.gov. County fairs offer a unique opportunity to experience the local foods, crafts, art, produce, livestock and more that each of our counties has to offer! Check the list below to find the dates for your county fair (or a neighbor!) and see all that New York has to offer this summer!

NYSAC News | Summer 2022

2022 County Fairs July 2-4

Grand Circuit Race Meet

July 5-9

Cortland County Junior Fair

July 7-10

Afton Fair

July 7-10

Madison County Fair

July 12-16

Yates County Fair

July 12-17

Jefferson County Fair

July 14-31

Orange County Fair

July 17-19

Putnam County 4-H Fair

July 18-23

Allegany County Fair

July 18-24

Chautauqua County Fair

July 19-23

Hemlock Fair

July 19-23

Lewis County Fair

July 19-24

Saratoga County Fair

July 20-23

Seneca County Fair

July 23-30

Genesee County Fair

July 25-30

Orleans County 4-H Fair

July 26-30

Ontario County Fair

July 26-31

Boonville Oneida County Fair

July 26-31

Broome County Fair

July 26-31

Clinton County Fair

July 28-30

Cayuga County Fair

July 28-31

Greene County Youth Fair

July 28-31

Onondaga County Youth Fair

July 29-31

Orange County Ag. Festival

July 30 August 6

Cattaraugus County Fair

August 2-7

Chemung County Fair

2022 County Fairs, con't August 2-7

Gouverneur & St. Lawrence Fair

August 17-21 Essex County Fair

August 2-7

Otsego County Fair

August 17-21 Oswego County Fair

August 2-7

Ulster County Fair

August 19-21 Grahamsville Little World's Fair

August 3-7

Niagara County Fair

August 20th

Sullivan County Youth Fair

August 5-7

Monroe County Fair

August 21st

Genesee Breeder's Assoc. Horse Fair

August 6th

Warren County Youth Fair

August 22-28 Washington County Fair

August 7-14

Franklin County Fair

August 23-28 Dutchess County Fair

August 8-13

Wayne County Fair

August 23-28 Trumansburg Fair

August 9-13

Tioga County Fair

Columbia County Fair

August 9-14

Schoharie County Sunshine Fair

August 31 September 5 August 31 September 5

Fonda Fair

August 31 September 5

Schaghticoke Fair

September 16-18

Long Island Fair

August 10-14 Chenango County Fair August 10-21 Erie County Fair August 13-20 Wyoming County Fair August 15-20 Delaware County Fair August 15-21 Stueben County Fair August 16-21 Altamont Fair August 16-21 Herkimer County Fair

tentative Livingston County Fair August 12-14, Sept. 16-18

Did you know that babies remember? Most people think that we don't have memories before age 3 or 4. When we think about a memory, most of us experience it as a story, with words and a narrative. Very young children do not have the language development that allows for the creation of a story. But, babies as young as 1-year of age can be diagnosed with post-traumatic stress disorder. Other parts of the developed brain do remember.

During the earliest years of life, we are building the foundation of our mental health, our social emotional well-being. This foundation is with us for the rest of our lives. We know that a house built with a strong foundation is able to stand up against the onslaught of storms. It works this way, too for our mental health. A person who developed a strong foundation in their earliest years is better able to stand against the onslaught of storms that life brings.

The New York State Association for Infant Mental Health is working to assure that EVERYONE who works with, or on behalf of young children, their families and caregivers understands and carries Infant and Early Childhood Mental Health principles in all they do.

What is your county doing to carry these principles in your work?

Visit us today & register for training to learn more - www.nysaimh.org/events NYSAC News | www.nysac.org

DEVELOPING NEW SOLUTIONS

Counties Bolstering School Resource Officer Programs Report by NYSAC Staff

n the aftermath of the horrific mass shooting at an elementary school in Uvalde, Texas, several county sheriffs across New York State are increasing the presence of School Resource Officers (SROs) and calling for additional resources for the program. Shortly after the shooting in Uvalde, Oswego County Sheriff Don Hilton told Spectrum News 1 that implementing effective school safety measures is one of his top priorities. The Oswego County Sheriff ’s department’s SRO program launched in 2019 and includes 13 officers to cover Oswego’s nine school districts. Sheriff Deputy Michael Gaita, who oversees the Oswego County program said, “What these guys do and what we drill into them is, basically, building relationships. You want to build a relationship. You want to provide security and peace of mind. And when you do those three things, now you start to humanize the police. They approach us. They hug us. We walk to lunch with them.”

In addition to placing an armed officer in every school building in the county, Sheriff Hilton is seeking additional upgrades to the county SRO program. “We’re working on a policy that will enhance the school districts, or the SROs, in the school districts. I'll be seeking funding from both the schools and from public funding to bolster this program,” he said. County SRO programs date back to 1996. The Putnam County Sheriff ’s Office became the first law enforcement agency to introduce the SRO program to New York State. Since its inception, highly trained uniformed deputy sheriffs have been assigned to middle, junior and senior high schools, as well as one elementary school in Putnam County. SROs are typically certified law enforcement officers who receive hours of specialized training and undergo a lengthy screening process. In Putnam County, SROs are assigned full-time to a particular school and work closely with individual teachers to create special programs and presentations that help increase student awareness and understanding of laws and personal safety. In addition to rural counties like Oswego, urban and suburban counties like Albany are also stepping up their SRO programs. Albany County Sheriff Craig Apple announced that the county would be adding extra deputies to Albany County schools. Sheriff Apple told WRGB News, “These SROs are more than an armed security person. They’re a person that can get in there and build a friendship with kids. They can see the kids or hear the stories of kids that are getting bullied and maybe befriend that kid and bring them in and see if there are any issues that are going on before something horrible happens.”

Oswego County Sheriff Don Hilton is working with several school districts to increase the number of school resource officers in the county. Photo by Payne Horning / WRVO News

NYSAC News | Summer 2022

NYSAC News | www.nysac.org

Bringing Substance Use and Mental Health Treatment on the Road By Albany County Executive Daniel P. McCoy

hen it comes to mental health and substance abuse programs and services, we can’t look to the past for solutions. Looking back shows us what we should not repeat, because those outdated policies have been a clear and resounding failure in terms of what we are seeing today. Furthermore, the events of the last 26 months have only made that conclusion even more obvious, as the isolation and financial turmoil caused by the pandemic and economic shutdown has only made these matters much worse. Consider that in Albany County alone there were at least 110 opioid overdose deaths in 2021. Compare that to the 99 deaths in 2020 and the 62 deaths in all of 2019. That is a 77% spike in annual overdose deaths between 2021 and 2019, and I know these alarming statistics are not unique to Albany County. These horrible tragedies are occurring at far greater rates across the state and the country. In 2021, more than 7,500 individuals received some form of service provided by our Albany County Mental Health Department during over 40,600 unique interactions.

We know the public need for assistance is there, so it’s our responsibility to be creative when it comes to how we are helping people struggling with addiction or mental health challenges. The old way of thinking in government was to wait for people to come to us to get assistance, and while it’s important to have headquarters and convenient satellite offices with doors wide open, we also need to find ways to bring services to people directly. Which is why Albany County has developed two important and innovative programs that bring mental health and substance abuse services on the road. The first is the Mobile Outreach Treatment Overdose Response (MOTOR) Program. The Albany County Department of Mental Health streamlined its community outreach and response efforts in April of last year. A team of addiction professionals and peers is available to provide support, linkage, and treatment to all parts of Albany County. Additionally, in a unique partnership with local law enforcement, MOTOR reaches out to overdose survivors with targeted interventions designed to provide rapid links to treatment. Currently, MOTOR is operating in the Towns of Guilderland and Colonie, with expansion planned for Albany, Cohoes, and Watervliet.

NYSAC News | Summer 2022

Another initiative, which was launched in June of 2021, is the Albany County Crisis Officials Responding and Diverting (ACCORD) Program, a collaborative effort with the Albany County Legislature and County Sheriff ’s Office to provide an alternative crisis response. Operating in the rural Towns of Berne, Knox and Rensselaerville, ACCORD pairs social workers from our Mobile Crisis Team with paramedics from the Sheriff ’s EMS Division to respond to non-violent situations where a law enforcement presence is not required. The key point to the program is having trained mental health and medical professionals respond to calls involving non-violent individuals experiencing a mental health crisis instead of police. This program diffuses and de-escalates situations, and pairs the right people together, while preserving public safety resources that allow officers to be available to respond to police matters. In the first six months, our pilot program responded to 240 calls from 100 separate individuals, and I’m looking forward to it expanding further in the coming months to ensure even more people experiencing a mental health

crisis throughout Albany County can get quick access to the services they need. The initial success of ACCORD has allowed us to bring in hundreds of thousands of dollars in state funding, along with knowledgeable researchers from the University at Albany School of Public Health and School of Social Welfare to ensure the program’s continuation and expansion. While the events of the last two plus years have been tragic and have likely done permanent damage to the mental well-being of countless individuals, it has also forced us to go back to the drawing board, get creative and find innovative solutions that we will have ready when the next catastrophe strikes. MOTOR and ACCORD are two new but promising initiatives that will allow us to change the outcomes for the better of many of those individuals and their families who are struggling, and I’m hopeful that they can serve as models for others.

NYSAC News | www.nysac.org

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NYSAC News | Summer 2022

Changing NYC’s Mental Health Emergency Response By Jason Hansman, Acting Co-Director, New York City’s Mayor’s Office of Community Mental Health

ew York City (NYC) has historically relied on public safety measures to respond to mental health emergencies. For decades police and ambulances have responded with transportation to a hospital being the primary option for individuals in crisis. In November 2020 the City announced a new health-centered approach to mental health emergencies: teaming emergency medical technicians (EMT) with licensed social workers to respond to calls that do not involve a weapon or imminent harm. This pilot known as B-HEARD (Behavioral Health Emergency Assistance Response Division) launched in June 2021 through a coordinated effort by the New York City Fire Department/EMS, Health + Hospitals, Department of Health, Police Department, and the Mayor's Office of Community Mental Health. Prior to B-HEARD, NYC made several investments to fundamentally improve crisis response and prevention. In 2018, the NYC Crisis Prevention and Response Task Force developed new strategies, such as reducing response times for mobile crisis teams from 17 hours to 2 hours; investing in Crisis Intervention Training for police officers; and creating Support and Connection Centers that offer short-term clinical and non-clinical services to people with mental health and substance use needs as an alternative to avoidable emergency room visits or criminal justice interventions. B-HEARD is accessible via 911 and mental health crisis calls do not need to be transferred to a new number. This ensures connection and continuity with existing emergency services, including comparable response times. Also, public messaging regarding what number to call in an emergency remains unchanged to avoid any confusion. When there is an emergency, everyone knows to call 911. The inclusion of clinical mental health professionals is an important part of the B-HEARD model. Having a licensed social worker paired with EMTs allows us to provide–for the first time ever– rapid and comprehensive mental health evaluations on-site in the community. It also facilitates transition to community-based services, including connection to peers and other paraprofessionals, and warm hand-offs to a hospital if necessary. To further ensure coordination of services, especially in the field, the EMTs and mental health clinicians are trained together for four weeks before responding to calls.

Providing individuals in crisis with more options can lead to better connections to ongoing supportive care while not compromising public safety. In the first six months of operation, 92% of individuals who received a B-HEARD response accepted assistance and only 46% of people assisted by B-HEARD were transported to a hospital for additional care – a much lower percentage than the traditional response, in which 87% of people were transported to a hospital. This means about 47% were served on-site or transported to a communitybased care location, with options for behavioral healthcare that were not previously part of emergency response. And everyone was offered follow-up care that could help prevent the next emergency. The pilot program has faced some challenges operating within several complicated systems, namely emergency services and mental health. In a time when mental health providers are stretched thin, it has been difficult to find providers that can accept individuals on the same day. We have taken steps to address this problem through community provider outreach and making referrals to the local Support and Connection Center, but more work remains to be done. Additionally, we are actively using strategies to grow the number of 911 calls routed to B-HEARD teams including hiring additional EMS call-takers, analyzing calls to ensure new and existing protocols are being followed, and piloting new approaches to triage. This is what a pilot is all about: learning as we go to make sure we get it right. Over the last year, B-HEARD has expanded from its original catchment area in East Harlem to the rest of Northern Manhattan and parts of the South Bronx, with further expansion to come in fiscal year 2023. Our hope is that other cities join us in taking a health-first approach to mental health emergencies as it can lead to better outcomes for cities, communities, and most importantly the individuals in crisis. To learn more about the B-HEARD initiative, visit https:// mentalhealth.cityofnewyork.us/b- heard. NYSAC News | www.nysac.org

A Groundbreaking Rural Mental Health Initiative for Youth By Sandra Bellassai, MPH, Herkimer System of Care Project Director

n August of 2019, Herkimer County, through our Department of Public Health, was awarded a four-year grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) to implement a System of Care approach to “support the provision of mental health and related recovery support systems to children and youth with serious emotional disturbance (SED) and those with signs and symptoms of serious mental illness.” Herkimer County is made up of mainly rural communities, has only one established city and is a federally-designated mental health provider shortage area. The three main goals of this project are to improve the mental and behavioral health of children attending school, improve the emotional and psychological strength of families, and reduce the number of youth involved in the juvenile justice system. In tackling these goals, we are adopting a gradual-layered approach of service delivery and expansion. In years one and two, we partnered with United Way of the Mohawk Valley to embed Family School Navigators (FSNs) into five of the main school districts across the county. The FSNs acted as liaisons between the families, schools, and the SOC project. Through working one-on-one with students and their families, FSNs were able to screen children and youth for early signs of SED and make referrals to mental health and support services as early as possible.

NYSAC News | Summer 2022

To date, we have connected and linked more than 250 youth and families to mental health services and supports within our local community. Once the FSN team joined our initiative and the number of youth served started to increase, we realized that the need for a centralized referral and intake system was necessary. In year two, we brought on the SOC Child and Family Team through a partnership with Integrated Community Alternatives Network (ICAN), composed of a Support Coordinator, a Referral Supervisor, and a master’s level Mental Health Counselor. These individuals work in tandem with the community to receive referrals, connect with families, conduct assessments, and link them to mental health and support services as quickly as possible. To address transportation barriers in our county, the Child and Family team carries out services wherever it is most convenient for the family. Once we had our centralized intake and referral system operational, we continued our efforts to increase mental health provider capacity and access by contracting with ICAN for “a la carte'' support services. Some of these include behavior management, mentoring, family peer support. During this time, we also began a new partnership with The Neighborhood Center to support their efforts in establishing a mental health clinic right in the heart of Herkimer, New York that would offer counseling and psychiatry services to local youth. The Neighborhood Center quickly became a heavily utilized resource in the county for outpatient mental health clinical services. By the end of year two, we were able to connect referred families to mental health providers within our developed System of Care network within 1-4 weeks from intake date.

In year three of implementation, we continue to offer all of the same mental health services, but have expanded our initiative to incorporate youth engagement efforts, and SEL learning and development for children in daycares. To be more specific, we have partnered with Catholic Charities of Herkimer County to increase school-aged youth engagement in our System of Care efforts. Through this collaboration, we are incorporating a Youth Advisory Council, developing an inter-county volunteer mentoring program, and creating more opportunities for our youth to develop leadership skills. Our work in engaging youth begins within the youngest population of Herkimer County, the children who attend daycare. Cornell Cooperative Extension of Oneida County’s (CCE) Mid York Child Care Council program is working alongside our initiative to ensure that daycare providers have evidence-based social-emotional learning curriculum to

implement in their daily routines. Our SEL educator with CCE provides direct outreach and support to daycare providers by implementing curricula within their programs to demonstrate how engaging, easy, and effective the lessons are. We have received positive feedback from providers and to CCE’s services. With support from CCE, various daycare programs are beginning to implement universal SED screening using the ASQ-SE for the children in their facilities. As a result, we have been able to support the children scoring “high” with services offered through the system of care that we have developed. To date, we have connected and linked more than 250 youth and families to mental health services and supports within our local community. We attribute this success in breaking down barriers to accessing quality services to the funding we have received from SAMHSA, in addition to the commitment and dedication of the organizations across our county.

NYSAC News | www.nysac.org

Bringing Selfcare Directly to Your Inbox By Portia Ingram, Director, Smart Start Suffolk

wo years ago, I could never have imagined we would be discussing, at great lengths, the impact of wellness initiatives on personnel during a pandemic. For many of us in government, we know and value public service but are not trained first responders so we lived in constant dissonance; we left our homes, partners, children, pets, and comfort zones to assist in the all-hands-on-deck calls to fight an invisible fight, often receiving only ounces of praise to the pounds of risk we faced. Stepping outside our doors and into an uncertain world forced many of us to take an intentional approach toward our health and well-being. As a government, we may often deploy employee programs to decrease risks and costs related to insurance plans. However, this time, it was about needing a constant reminder that our well-being is innately important, and that without it, it would be tough to keep our head in the game. Not just in work, but in life and within what was now termed “the “new normal.” In April 2020, Chief Deputy County Executive Lisa Black, tasked me (then Deputy Director of Community Affairs) and Ann Marie Csorny, LCSW-R (former Director for the Division of Community Mental Hygiene), and later Michelle Zarifis (a County Executive Assistant), with building out a wellness newsletter for Suffolk County’s 12,000+ employees. The goal of the newsletter was not to force anyone to engage in self-care acts, but to bring awareness to what self-care can look like and how it can manifest in our day. For over two years, we have offered an assortment of classes and events in our Behavioral Health & Wellness Campaign newsletter. From gardening, to meditation, to caregiver support classes, we have linked employees to resources for various needs and lifestyles. Through this newsletter, we have provided important updates and resources on COVID-19 as well as mental health programs available through county health insurance. Since its inception, the newsletter has also partnered with the Long Island Council on Alcoholism & Drug Dependence (LICADD), the Cornell Cooperative Extension of Suffolk County, and our very own Chief Diversity & Inclusion Officer, Retha Fernandez (who is Chopra Meditation certified!), for live meditations to support our workforce.

NYSAC News | Summer 2022

What started out as a newsletter became a community. Many employees receiving the newsletter would write back expressing their gratitude. Others would check in and offer suggestions and feedback about programs they would like to see. It became apparent that when people felt they were cared for, they became more engaged with the programs and in turn, became happier. At a time when nothing felt perfect and the future was uncertain, voices of gratitude and optimism not only helped the recipients of the newsletter but helped those of us creating it as well. Today, we continue to send out a weekly newsletter as a reminder to our employees that their health and well-being is a top priority in Suffolk. Practicing self-care is not only important during a pandemic, but also in our day-today lives. It has proven to us time and again that our most precious resource in government is after all, our workforce. Keeping our employees healthy, keeps our community healthy.

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A Natural Rx for Veterans By Assemblymember Didi Barrett, 106th Assembly District, and Lt. Col. (ret.) Aaron Leonard. Campaign Manager, Sierra Club Military Outdoors

n the most recent federal budget, the Department of Veterans Affairs received $13.2 billion to fund mental health services for veterans. This was an increase of nearly $3 billion over the previous year, and it shows that mental health care is an increasingly serious issue facing the VA -- as it is throughout the state and country. These funds provide crucial health care to veterans, but more and more, veterans are pairing these stateof-the-art treatments with a time-honored one – spending time in nature. The transition from military service to civilian life is not always smooth. Many veterans experience considerable challenges upon returning home. Exposure to physical and mental trauma, in combat or simply through regular duties, and long deployments away from friends and family can leave scars -some visible, many invisible. For these brave veterans, their service may have ended, but its weight can linger long after they have made the transition. Some of these less visible effects of war, like traumatic brain injury, post-traumatic stress, and military sexual trauma can be equally or more disabling than an obvious physical injury. That can make it even harder to adjust to life back home, and for veterans who are Black, Indigenous, or People of Color, systemic racism encountered both during service and after returning from deployment can exacerbate that trauma. For far too many veterans, this transition ends in tragedy. The great outdoors offer many veterans a different path. With its proven mental and physical health benefits, spending time in nature offers a compelling option for veterans to heal from service-related trauma. Research into the effectiveness of outdoor recreation as therapy shows significant improvements in mental and physical well-being, social function, and outlook on life. Recreation on public lands can be very effective whether it’s part of a structured program or simply with family and friends, while ultimately reducing reliance on costly prescription medication. And with a lower barrier to entry and potentially fewer stigmas than clinical treatments, these outdoor activities may be especially effective for the veterans most in need of help. Unfortunately, nature is not always accessible to all veterans. Barriers like distance, lack of transportation or unfamiliarity with outdoor activities often prevent veterans from experiencing the full benefits of time spent in nature. Fifty percent of veterans likely recreate on our beautiful public lands, but only 1-2 percent are able to do so as part of structured therapy programs.

NYSAC News | Summer 2022

Here in New York, we are working to change that. Our state took an important step on November 11, 2020 with the enactment of the Outdoor Rx Act, which seeks to dismantle the barriers that have kept veterans from healing on New York’s public lands and waters. Now we’re taking the next step; the New York State Division of Veterans Services, Veterans Service Organizations, environmental and outdoors groups, universities, and more are partnering to launch the Outdoor Rx Coalition. By combining our efforts, we will ensure that policymakers have the latest research and evidence to support the veterans most in need of the healing power of nature. Our early efforts called for including more veteran-focused programming in parks, on waterways and on public lands; simplifying public transit for veterans to be able to access these green and open spaces; and revising fee structures to ensure that a lack of funds doesn’t prevent a veteran from healing in nature, but we can’t stop there. We need improved coordination between state and county agencies that offer veterans support. We also need to improve outdoor education and infrastructure, including increasing access in parks to people of all abilities and strategically upgrading transit systems. These improvements would improve health and quality of life not only for veterans, but for all New York residents. The outdoors can provide critical therapeutic and healing benefits for veterans struggling with post-traumatic stress and other combat-related trauma. Right now, too many veterans do not have access to these benefits. The Outdoor Rx Coalition is working to change that. Veterans served to protect our country and its public lands and waters. They should be able to heal on them.

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NYSAC News | Summer 2022

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Mental Health First Aid Solution Delivered by National Association of Counties & National Council for Mental Wellbeing By Brandon Natsuhara, National Program Director of Technology Partnerships, NACo FSC

he National Association of Counties (NACo) and the National Council for Mental Wellbeing have established a new partnership to make Mental Health First Aid (MHFA) training available to county employees across the country. MHFA is a skills-based training course that teaches participants to identify, understand and respond to mental health and substance use challenges in their peers, friends and colleagues. While one in five adults in the U.S. report living with a mental health challenge, only 10 percent of employees feel their workplace is free of stigmas about mental health. With counties employing 3.6 million workers, or 1 percent of the U.S. population, MHFA training will help county workers assist during a crisis or until professional treatment is obtained. “Most of us know how to help if we see someone having a heart attack — we’d start CPR, or at the very least, call 911. But too few know how to respond if we see someone having a panic attack or if we are concerned that a family member, friend or coworker might be showing signs of mental health and substance use challenges,” said NACo Executive Director Matthew Chase. “Mental Health First Aid training will provide tools to county employees to intervene appropriately in a mental health crisis.” An enterprise-level approach to mental health awareness and training can improve early recognition and encourage help-seeking, enhancing utilization of timely and appropriate support, and perhaps limit the impact mental health issues can have on the work environment. Many county and local governments have used MHFA at Work to build cultures of caring and resilience. This new partnership will support elected officials and county staff with their own mental health and well-being needs, as well as create a framework to destigmatize mental health and substance use challenges as they provide community residents with more equitable access to quality mental health and substance use treatment services. Learn more at www.naco. org/MHFA.

NYSAC News | Summer 2022

Mental Health First Aid (“MHFA”) at Work: General Awareness Training MHFA at Work is a high impact, skills-based training program that teaches employees how to offer help to a person who may be developing or is suffering from a mental health concern or crisis. Employees learn how to act in the same way they would when they see someone having a physical/medical problem or emergency. Similar to physical First Aid training, employees gain the skill and confidence to provide direct assistance and support to a person in need. When necessary, employees learn how to reach out for emergency services on the other’s behalf.

General Awareness Focus on recognizing the patterns of thoughts, feelings, behaviors, and appearance that show there might be a challenge rather than on a specific disorder. Participants learn the MHFA Action Plan and how to apply to non-crisis and crisis situations. By the end of the course, participants will be able to:

Who should take MHFA at Work: General Awareness DEPARTMENTS •

Transportation & infrastructure

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Public Safety

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Human Safety

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Community Health

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Call center staff

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Describe the purpose and role of Mental Health First Aid

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Identify the impact of mental health challenges and recovery on the well-being of adults in the workplace

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Describe the principles of workplace safety and privacy

ROLES AND TITLES

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Recognize the signs and symptoms of mental health challenges and how they impact the workplace

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Human resources and benefits partners

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Explain and practice the 5 steps of the Mental Health First Aid Action Plan, and

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Senior leaders and front- line managers

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Clinical and wellness staff

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Discuss appropriate methods of self-care for individuals in the workplace.

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Call center staff

2021 Training Outcomes (N=3,898 RESPONDENTS)

Mental Health Essentials Mental Health Essentials Seminars provide a high-level introduction to workplace well-being and reinforce the principles of MHFA to foster peer support and engagement. The session includes information on best practices in the workplace and guidance on how to support each other and ourselves during this crisis, with a focus on the impact of trauma, the importance of team engagement, self-care, and mindfulness.

3. Explore strategies to help reduce stigma, build resiliency, and make wellness a priority so we can move forward together. Mental Health Essentials is designed for the entire workforce and can be delivered to small and large groups of employees

The seminar is designed to meet the following learning objectives: 1. Define and increase our awareness of mental wellness, mental illness and recovery. 2. Identify common signs and symptoms of mental health challenges in the workplace. NYSAC News | www.nysac.org

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NYSTEC County Services include: • Strategic Roadmap Plan for an Improved Emergency Operations Center • Cybersecurity Risk Assessments and Evaluations of Networks and Infrastructure • Multiple-Phase Rollouts of Wireless and Public Safety Communication Systems • Independent Verification & Validation (IV&V) Review • Technology and Vendor Proposal Evaluations • Next-Gen 911 and Emergency Management Consulting

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NYSAC News | Summer 2022

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Advertiser Index Absolute Auctions & Realty, Inc............................ 24 Auctions International, Inc.................................... 54 Barton & Loguidice.................................................. 4 Broome County Purchasing Alliance.................... 27 C.O.D Deliveries LLC............................................. 29 CanaRx.................................................................... 47 CDPHP.................................................................... 29 Collar City Auctions Realty & Mgmt, Inc............ 50 findhelp................................................................... 21 FirstNet Built with AT&T...................................... 35

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Fiscal Advisors & Marketing, Inc............................ 6 Municipal Electric & Gas Alliance, Inc................. 60 N.K. Bhandari, Architecture & Engineering, P.C..................................................... 45 Nationwide Retirement Solutions........................... 6 New York Power Authority.................................... 39 New York Power Authority.................................... 51 NYS Association for Infant Mental Health........... 37 New York State Health Insurance Program.......... 55 NYMIR.................................................................... 59 NYS Industries for the Disabled.............................. 4 NYSTEC.................................................................. 54 PERMA...................................................................... 2 PFM Purchasing Card............................................ 42 PKF O'Connor Davies, LLP................................... 32

• NYSHIP is available to virtually all public employers across New York State • Over 800 counties, cities, towns, villages, school districts and special districts participate in NYSHIP • More than 1.2 million public employees, retirees and their families have health insurance through NYSHIP

ProAct, Inc.............................................................. 13 ProAct, Inc.............................................................. 27 Siemens Industry, Inc............................................. 23 Systems East, Inc....................................................... 3 UnitedHealthcare.................................................... 17 Wendel..................................................................... 35 Workday.................................................................. 51

A unique health insurance plan developed for New York’s public employees For additional information regarding The Empire Plan or the Excelsior Plan, public employers may visit our website at www.cs.ny.gov or email the Public Employer Liaison Unit (PELU) for the New York State Health Insurance Program at PELU@cs.ny.gov. Employee Benefits Division of the New York State Department of Civil Service

Committed to the Community Madison County Mental Health Task Force By Samantha Field, Madison County Public Information Officer and Teisha Cook, Madison County Director of Community Mental Health Services

year ago, in April of 2021, Madison County Board Chairman John M. Becker created the Mental Health Task Force to assess the impact of the COVID-19 pandemic on the mental health and well-being of the community. Although behavioral health issues were present prior to the pandemic, the pandemic experience heightened the need for programs and services to address these issues in the Madison County community. Madison County operates an outpatient mental health clinic, and during the pandemic the number of individuals seeking services increased dramatically. Prior to the pandemic, the county clinic served approximately 850 clients at any given time; currently, the clinic is serving nearly 1,500 clients. It was the increase in the utilization of services that led, in part, to the creation of the Mental Health Task Force. The Madison County Mental Health Task Force is comprised of: Chairman of the Board John M. Becker County Administrator Mark Scimone Vice-Chairman of the Board Clifford Moses Director Office of Emergency Management Dan Degear Director of Community Mental Health Services Teisha Cook Public Health Director Eric Faisst Commissioner of DSS Michael Fitzgerald The Task Force retained the services of Mat Roosa, LCSW-R to assist the county in the process of developing a needs assessment, and implementing projects related to the assessment. Roosa has expressed his appreciation of Madison County’s effort, stating, "I have been impressed by the level of executive support for mental health and wellness in Madison County. The leadership is actively engaged in support of a number of best practice implementation efforts."

NYSAC News | Summer 2022

There have been several phases of the needs assessment over the course of the last year. The first phase involved surveying many key stakeholders and groups in the community. These included: teachers, students and school district staff, senior citizens, faith-based communities and other Madison County residents. The survey was distributed broadly to try to obtain the most feedback possible from county residents. From these assessment surveys emerged a bigger picture of what the community identified as their struggles and needs. Key themes arose and responses reinforced some common understandings of the needs of the community. Students, parents, and teachers all reported a significant increase in stress experienced by students and a need for additional mental health and well-being supports. Populations with limited access to services, such as seniors with mobility issues and individuals in rural regions of the county reported a desire for enhanced

ways to access supports. In addition, social determinants of health such as social connections, income and natural supports have all shown a significant impact on mental wellbeing. Several project areas have been identified to address the needs identified.

Enhancing School based mental health/ wellness services and supports Madison County has been meeting with each school district to assess their needs and to identify districts who may want a satellite county mental health clinic at their schools. These school-based satellite clinics are the first to be established in the county, and offer children services in their own school, where clinicians can collaborate with school staff, enhancing the overall service the child receives.

Working with Primary Care Physicians to provide resources and linkages to services. Wellness/ Mental Health related infrastructure projects •

Enhancing and promoting existing behavioral health crisis services

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Address low-income housing issues

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Enhancing broadband access across the county.

In addition to the County Mental Health Clinic, the department also works closely with law enforcement through the Crisis Intervention Team. The team is composed of various law enforcement officers from the Madison County Sheriff ’s Office, Oneida City Police Department, the behavioral health agencies in the county, and other local agencies. The CIT training that law enforcement participate in gives them strategies to deal with individuals who are in crisis or need of support. The County Mental Health Department and the CIT officers work closely with the Mobile Crisis Team. An offshoot of the CIT team is the Madison County 911 Diversion Program, which started about a year ago. Madison County 911 communicators are trained to ask a series of questions if someone is having a mental health crisis, and if certain criteria are met, the dispatcher can connect that individual to a county Mental Health clinician. Madison County 911 identified that individuals often just need to talk to someone and that sending the police, or an ambulance is not the best use of resources.

Lastly, in December 2021, a new program was implemented with the Sheriff ’s Office involving telehealth. When officers in the field meet an individual who needs clinical support, they use tablets to enable telehealth contact with the clinic case worker. This prevents the need for transportation to the county clinic or the hospital.   Madison County is committed to the well-being of our community. Our leadership and employees understand that to make our community even better, we need to dedicate the time and effort to connect those who need assistance with the correct resources. Those resources could range from monetary assistance, health care, behavioral health, or even to find out where is the best place to get a cheeseburger north of Route 20. Madison County Mental Health Task Force is working hard to make sure we have those resources, and the connections are made so the needs of our residents are met.

NYSAC News | www.nysac.org

Getting ‘Productively Angry’ By Terri Morse, LMHC, CASAC-Master, Director, Essex County Mental Health and Community Services

his week, a colleague sent this message to my inbox.

107,000 fatal overdoses. Fentanyl seizures at the border through the roof and more acres planted in Afghanistan than ever before. Despite the opium market being saturated, the price of opium went up last week from $55/kilogram to $63/ kilogram due to high demand from exporters. Things are going to get worse, much worse. The Taliban and Iran are doing their best to make addicts in the west and China is doing the same with fentanyl. I hate to bring news of doom but what I predicted last year is happening. About every two weeks I receive similar pleas from this individual. I truly appreciate them, but they’re frustrating. Not in a bad way, but they provoke a sense of powerlessness – the way you would feel if someone challenged you to swim up the falls on the Niagara River. The most exasperating aspect of these messages is the sentence that’s missing, though certainly implied: “Do something!!!”

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Increase prosocial bonding

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Set clear, consistent boundaries

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Teach “life skills”

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Provide caring and support

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Set and communicate high expectations

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Provide opportunities for meaningful participation

These messages, and their disguised plea, spur me on as a Director of Community Services in New York State to act, get groups together, and solve the problem. However, this problem, and other systemic problems like them, will never be solved by one person. Nor will they be solved with governmental policies, or through the allocation of oodles of money. Nope! It is going to take a lot more than that.

We are most excited to have over 58 active and enthusiastic members of BRIEF that include representatives from Essex County’s Department of Social Services, Health Department, Mental Health, Head Start, case management organizations (adult and children), local hospitals, Probation Department, Sheriff ’s Department, Community Services Board, Board of Supervisors, providers from New York State Office of Mental Health, Office of Addictions Services And Supports, and Office of Persons with Developmental Disabilities, schools, BOCES, primary care physician offices, youth commission, nurses, pediatric case managers, and family peers.

So, what’s it going to take to address my friend’s alert? If you want to reduce supply, you must reduce demand. It’s the only way. It’s simple in theory, but tough in practice. How do you reduce demand?

Whereas the structure of human services in the past was more crises-driven, and we had to wait for someone to develop an actual mental health diagnosis before we could offer help, BRIEF is focused on prevention.

Well, in Essex County we’re focused on reducing demand through building a System of Care. We call ours BRIEF, which stands for Building Resilience in Essex Families. The vision of BRIEF is, “All families in Essex County will reach their full potential and achieve wellness.”

Many of us got tired of watching the six-year-old who had a strong affinity for bullying develop into a sixteen-year-old who ran afoul of the law, quit school, and had no real focus on the future. The founders of BRIEF got…productively angry. Now, we’re focused on building and expanding services targeted on the birth-to-five population more than ever and supporting those who are raising them. Being a parent or caregiver is the most difficult job, especially now. They are not alone, and we want to partner with those who hold the future in their hands.

BRIEF will promote a proactive system that focuses on education, encourages empowerment, builds resilience, and reduces stigma for all families in Essex County. Why did we choose to focus on resiliency?

Because we believe that resiliency – not the “pull yourself up by your bootstraps” or “suck it up buttercup” resiliency of my childhood – but promoting the components of the following list which stem from the work of Nan Henderson.

NYSAC News | Summer 2022

In Essex County, the BRIEF coalition is taking a systemwide, community approach to strengthening our community members from the very beginning, because if we don’t, we will repeat the patterns of the past that have led not just to a greater, generation-transcending demand for drugs, but to shattered families, broken social structures and unhappy lives. We can break these patterns, not with the help of a few, but with the help of many. All we have to lose is a monthly message in my inbox.

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Clean Energy is Local Energy In 2013, MEGA partnered with Gravity Renewables to explore opportunities to reinvest in New York’s existing clean energy infrastructure. Since then, our innovative program has resulted in millions of dollars in savings for our members and in reinvestment in hydropower projects that will benefit local communities for generations. MEGA’s partnership with Gravity Renewables is one example of how clean energy strengthens communities, creating opportunities for • Job Creation • Recreation • Historic Preservation • Educational Outreach • Emissions Reductions

Tompkins County purchased clean power from Gravity Renewable’s Waterloo hydroelectric powerhouse to meet its municipal electricity demand. The partnership enabled reinvestment in the circa-1910 facility which is critical to the local community and management of Seneca Lake water levels. Here Tompkins County and State officials celebrated the rededication of Waterloo’s powerhouse as the Stu Stein Powerhouse, in honor of Stu Stein, a New York clean energy visionary.

Summer 2022: Confronting our Mental Health Crisis

Articles inside

Getting ‘Productively Angry’

Mental Health First Aid Solution

Bringing Substance Use and Mental Health Treatment on the Road

Changing NYC’s Mental Health Emergency Response

Bringing Selfcare Directly to Your Inbox

A Natural Rx for Veterans

County Fairs Ready to Show What’s Great in New York State

A Groundbreaking Rural Mental Health Initiative for Youth

Counties Bolstering School Resource Officer Programs

A Dual Pandemic: The Public Health and Mental Health Crisis

NYSAC Finance Director Dave Lucas Honored By County Finance Officials

Unseen Mental Health Struggles of Student Athletes

Putnam’s Multi-Faceted Approach to Improving Mental Health

Top 10 Reasons to Attend the NYSAC Fall Seminar

Update on the Enacted Budget & Post-Budget Review

Restoring Common Sense to Competency Restoration

Affiliate Spotlight: NYS CLMHD