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STATE HOUSE Commission pursues 'vaccine' for addiction, mental illness

Weymouth News - 5/31/2017

Editor's note: This article was submitted by the office of State Rep. Jim Cantwell, D-Marshfield.

Can we "vaccinate" against addiction and mental illness?

That was the question posed by the Special Legislative Commission on Behavioral Health Promotion and Upstream Prevention during its second official meeting, "The Promise and Science of Prevention," held this month on Beacon Hill.

Although the "behavioral health vaccine" wouldn't be an injection, the answer was a resounding "yes" from the national giants of prevention science who presented to the commission. The vaccines will come in the form of school-, home- and community-based prevention programs designed to diminish the risks a person will develop an illness or addiction disorder.

State Rep. Jim Cantwell, House Chair of the Commission, said, "The commissioners and our presenters represent the brightest minds in the public and private sector across key fields - public safety, public health, healthcare, addiction, insurance, social work, and education. We've come together around the belief that if we can act early, we can save individuals and families from tragedy and promote a happier and healthier commonwealth."

The commission meeting, which was opened with remarks from House Speaker Robert DeLeo, featured National Academy of Medicine prevention scientists, Dr. William Beardslee of Harvard University'sBoston Children's Hospital, Dr. Laurel Leslie of Tufts University, Dr. Jeff Jenson of University of Denver, and Dr. J. David Hawkins, Endowed Professor of Prevention, University of Washington.

The scientists helped author the landmark academy report, "Unleashing the Power of Prevention," which called for investments in programs to prevent mental, emotional, and behavioral disorders that now pose the most significant challenges to health in the Nation.

Beardslee, who discussed "Family Talk" a program that helps families identify the effects of parental depression, improve communication, and promote resilience, said, "We do have strong evidence that prevention programs work. The challenge is to implement them widely, so that every child and every adolescent has access to both treatment and preventive services."

Although Massachusetts ranks #2 among states in overall health, Massachusetts scores in the lower half of the pack on behavioral health rankings, including excessive drinking (#38), violent crime (#33), drug deaths (#31), frequent mental distress (#31), as well as health disparities (#46).[i]

J. David Hawkins, Ph.D. Endowed Professor of Prevention, University of Washington "Prevention scientists have developed cost effective policies and programs for preventing behavioral health problems like alcohol, opioid and other drug abuse, violence, and mental illness. It is exciting to see the interest of the Massachusetts legislature in unleashing the power of prevention to stop these problems before they ever develop."

With a modest but priceless Drug Free Communities federal grant, Scituate, MA, has implemented proven programs and, in five years, drinking is down 18 percent, binge drinking is down 21 percent, and marijuana use is down 20 percent among high school students.

Annmarie Galvin, chair of the ScituateFACTS substance use prevention coalition, said, "The wheel has been invented, we all need to use it! Sometimes folks with the best of intentions come up with what they think is a prevention strategy. Like, for example, raising awareness about opioid use. But it isn't supported by prevention science or evidence and it doesn't work."

Among the mix of programs presented by the meeting was Life Skills Training, a school-based program that teaches young people social and behavioral skills.[ii] Dr. Jenson noted that as one of the most well tested programs for preventing substance misuse, life skills training has an estimated $15 in societal benefits for every $1 spent.

The group also heard a presentation on the Good Behavior Game (GBG)[iii] from Dr. Dennis Embry of the PAXIS Institute. In the short term, GBG, a 1st grade classroom intervention, helps teachers manage their classrooms and to promote academic success but over the long term the game protects participants from addictive disorders, suicide, and violent aggression. Like the steep payoffs from other prevention programs, GBG has a return on investment estimated at $31 in benefits to every $1 spent.

Those kinds of returns are a potential windfall for the state, which is grappling with how to reduce the enormous costs of acute treatment and recovery, including addiction services.

The commission, chaired by Cantwell and Sen. Jen. Flanagan, is made up of 24 experts and state leaders, including Senator Patrick O'Connor, Rep. Kim Ferguson Chief Justice Paula Carey, DPH and DMH Commissioners, the Director of the Health Policy Commission, and representatives from organizations like the Massachusetts Public Health Association and the National Association of Social Workers. They'll be developing recommendations for the Legislature on how to prevent behavioral health disorders over the next year.

The next big question for the commission is how to pay for it all. A public meeting will be held Tuesday, June 6 at 1:30 p.m., "Financing Prevention," at the Health Policy Commission. You can learn more about the Commonwealth's Promote Prevent Commission at PromotePrevent.com.

[i] Source: America's Health Rankings, 2016 Annual Report, American Public Health Association, with the United Health Foundation

[ii] http://legacy.nreppadmin.net/ViewIntervention.aspx?id=109

[iii] http://goodbehaviorgame.air.org/evidence_base.html