Informing Decision Making for Better Community Behavioral Health Outcomes

Grappling with behavioral health problems, especially substance use and abuse, is a continual struggle for many communities across the country. A particular challenge for community leaders is that the occurrence of these issues varies tremendously from location to location. Therefore, it is important for local leaders to have access to accurate data about substance abuse in their specific geographic location, in order to be prepared and well-equipped to deal effectively with the issue.

Scott Loveridge is the director of a new national project called Community Assessment and Education to Promote Behavioral Health Planning and Education (CAPE), developed to provide resources for local decision makers to get a better understanding of the behavioral health concerns in their region.

"There are quite different ways how this plays out at the local level," said Loveridge. "So we need to do a better job helping decision makers figure out what's going on in their communities, and do some early warning."

Using substance use data provided by the Substance Abuse and Mental Health Services Administration (SAMHSA), for example, local leaders could see that the percentage of individuals in Utah with any form of substance use disorder is 4%, whereas in neighboring Nevada, the percentage is 12.6%, more than three times higher. And the variation within the respective states, from city to city, may actually be even greater than between states. When the different forms, types, and modes of substance use are factored in, the variables are exponential.

Loveridge has long had a passion for understanding and finding ways to alleviate societal conditions affecting community development. With a background in agricultural economics, his early work as a research assistant at MSU in the mid-1980s provided analysis for agricultural issues in Michigan and abroad. His subsequent appointments at the University of Minnesota and West Virginia University focused extensively on research and outreach activities in the area of regional and community economic development. Back at MSU since the year 2000, Loveridge has come full circle as both a tenured professor in the Department of Agricultural, Food, and Resource Economics and the director of the North Central Regional Center for Rural Development (NCRCRD), blending his dual love for agriculture and community development.

Funded jointly by the USDA and Land Grant Universities, the NCRCRD is one of four regional centers in the U.S. that collaborate with state Extension professionals, researchers, and local partners to enhance rural development and to work on projects that address cross-regional issues.

Community Assessment and Education to Promote Behavioral Health Planning and Education (CAPE)

CAPE is one such project. With funding from SAMHSA and facilitated by the U.S. Department of Agriculture's National Institute of Food and Agriculture (USDA/NIFA), CAPE's goal is to look at ways in which local health decision makers (such as hospital leaders, elected officials, law enforcement, and mental health treatment agencies) are currently gaining information on the behavioral health practices in their communities and how access to needed information can be increased.

"The local leaders are really the players, here," explained Loveridge. "They control vast resources, and they make literally hundreds of small decisions that potentially affect community behavioral health. They really know their constituents, but they vary in their knowledge of community behavioral health trends and trend drivers."

The project will take place in phases. The first phase involves conducting a survey of local health decision makers in eight pilot communities to find out what sources of information they are currently using to gauge behavioral health in their community. In the next phase, the design team will use information obtained from the surveys to design a national curriculum—an educational tool kit—as a resource for decision makers. Finally, the team will conduct trainings with the tool kits for local decision makers and provide feedback to improve the materials.

A Strong National and Local Partnership

CAPE involves the collaboration of many partners. Brent Elrod, national program leader for community and rural development for USDA/NIFA, helped launch the program at the federal level by establishing an interagency agreement with SAMHSA and then the four regional rural development centers, with MSU in the lead through the North Central Regional Center for Rural Development.

"This is truly a collaborative effort," said Elrod. "SAMHSA's investment brings the expertise of the Regional Centers for Rural Development, our land-grant university partners, and the Cooperative Extension System to the ongoing effort to improve behavioral health outcomes in communities across America. Helping decision makers understand where to find the relevant data that is also specific to their locale will promote more effective behavioral health policies and programs."

SAMHSA is a division of the Department of Health and Human Services that creates systems of measures and ways to gather meaningful data and make it accessible to communities. Dee Owens heads up SAMHSA's Center for Behavioral Health Statistics and Quality. She is thrilled with the strong partnership aspect of the CAPE project, which will enhance the SAMHSA's goal of quickly getting behavioral health data into the hands of community health decision makers.

"We get information out as quickly as possible," said Owens. "But sometimes it's not quickly enough. If we can work together in this project to get those measures, and get them into a tool kit where they're sensible, and can be used, then at the community level you can be able to find out what's going on and be able to target scarce resources where most needed."

Elrod and Owens work very closely with Loveridge and each of the four regional rural development centers, who in turn, work with a cadre of professionals from across the country, including state Extension personnel, media specialists, post-docs, regional community behavioral health specialists, and practitioners from many disciplines, such as medicine, economics, and sociology—all of whom work together to gather data, make community contacts, design and develop the curriculum, deliver the training, and evaluate the materials.

Expected Outcomes

As a result of the project, the CAPE team will have an understanding of how local leaders are getting their community behavioral health information, and local leaders will have a tool kit with sources of valuable data and training programs to inform their decision-making. According to the CAPE website, the ultimate goal is for this process to lead to "better benchmarking of health investments and goals, and in improved overall public health."

"Local leaders make very rational decisions based on the information that comes to them about their own program areas," says Loveridge, "With this project, we hope to engage groups of them in holistic decision making that not only impacts their own areas but makes connections to upstream and downstream consequences as well."

For more information visit http://healthbench.info.