Issue 7
April-May 2023
Welcome
Hello, fellow Illinoisans!
I hope as we transition into spring you have the opportunity to move about and experience increased health, wealth, and joy. As you all know, May is Mental Health Month. We encourage everyone to invest in their mental wellness, recognizing wellness is more than the absence of illness, it includes experiencing joy and thriving. Moreover, mental health is essential to a person's overall health and thanks to legislation like the Mental Health Parity and Addiction Equity Act. Which eliminates the practice of unequal health treatment and improves access to much needed mental health and substance use disorder treatment through more equitable insurance coverage.
Please be intentional in connecting with your support systems, whether that is family, friends, co-workers or members of your faith community. The U.S. Surgeon General, Dr. Vivek Murthy indicates loneliness is as deadly as smoking. We invite you to cultivate a culture of healthy connections as we enjoy the warmer, sunnier, and longer days ahead.
Be well,
David T. Jones
Chief Behavioral Health Officer
Mental Health Month
May is Mental Health Month! Observed since 1949 in the United States, this designation calls attention to the importance of acknowledging and honoring mental health as a priority in our nation. In Illinois, there is work happening every day to cultivate both a culture and infrastructure that acknowledges and supports the behavioral health of all Illinoisans, regardless of insurance status or zip code.
Below, you will find resources to utilize whenever you find yourself in need:
Help is Here: Talk to Someone
Self-Care Cheat Sheet (PDF)
Hope Starts With Us: You are NOT Alone
NAMI Illinois
Behavioral Health and the School System
It's important to remember that schools in Illinois have many behavioral and mental health resources available for students, families, and communities. The Illinois State Board of Education (ISBE) website is an excellent resource for learning more about these resources and supports. Here are a few highlights:
Anyone with questions is welcome to contact ISBE's Wellness Department with questions about mental and behavioral health supports in schools by calling 217-782-5270.
Upcoming Visit with the International Initiative for Mental Health Leadership (IIMHL)
In July, the Chief Behavioral Health Office will host a visit with leadership from the International Initiative for Mental Health Leadership (IIMHL).
The International Initiative for Mental Health Leadership (IIMHL) is a global behavioral health learning network. The purpose of IIMHL is to bring together behavioral health leaders from around the world to share innovations and problem solving around the shared goal to promote mental health and well-being for all. Illinois is excited to host IIMHL's President and CEO Steve Appleton on July 25 & 26 to learn about the Illinois behavioral health systems' successes and challenges. Stay tuned for more information about how to get involved!
Xylazine in Illinois
Xylazine is a non-opioid veterinary tranquilizer that is being found more often in illicit heroin, fentanyl, or benzodiazepines (benzos). It is known as "tranq" or "tranq dope." Xylazine causes a long, deep sedation and is being added to illicit heroin, fentanyl, or benzos to extend the sedative effect. Adding xylazine also greatly increases the chance of overdose. Xylazine was detected in 45 Illinois overdose deaths in 2020 and has been detected in more than 200 overdose deaths in the state in 2022 (Illinois Department of Public Health, Vital Records). The dramatic rise in two years suggests it is quickly becoming a common drug in Illinois.
Xylazine is not approved for human use and has been associated with severe wounds. The soft tissue wounds occur across the body, regardless of the use (injecting, smoking, swallowing, or snorting). These wounds can become severe quickly and require medical attention. Xylazine is also associated with other serious injuries caused by the fast, deep sedation, such as falling or being in a position that restricts blood flow or breathing for an extended time.
Regular users of xylazine can experience withdrawal symptoms, including anxiety, irritability, restlessness, and a feeling of unease. However, there are treatment options to help manage the withdrawal symptoms in a medical setting, which can be accessed using the Illinois Helpline listed below.
There is currently no recommended reversal agent or "antidote" for xylazine. Since xylazine is not an opioid, naloxone, commonly called by a brand name "Narcan," will not reverse the effects of the drug; however, xylazine is commonly mixed with fentanyl or heroin so the use of naloxone is still recommended when an overdose is suspected. The sedative effects are strong, and the person may not become fully alert with naloxone. If the person is breathing, they do not need more naloxone. Make sure they are in a recovery position and watch them to ensure their safety.
Illicit substances are not regulated and pose a significant risk of harm. If taking illicit substances, there are precautions that can be utilized. For example, consider testing the substance for fentanyl using fentanyl test strips. Xylazine test strips are now available and can be used to detect xylazine in substances. Also, carry naloxone and do not use substances when you are alone.
Importance of Test Strips in Harm Reduction Strategies
An important consideration for providers is to educate patients about the use of test strips and other community-based drug testing services to detect fentanyl, xylazine, and other synthetic opioids that may be in a drug sample. As mentioned above, Xylazine is a non-opioid tranquilizer used as a sedative, analgesic, and muscle relaxant in animals such as horses and cattle. In recent years, xylazine has emerged as an adulterant in recreational drugs such as heroin. Combining xylazine with other drugs that cause central nervous system depression compounds the sedative effects and can increase the risk of overdose and death. Evidence-based harm reduction strategies such as the use of fentanyl and xylazine test strips are an important resource for individuals to use as an option to check for the presence of these substances in their drugs.
Individuals should be encouraged to engage in harm reduction behaviors to test illicit drugs and pills that are obtained or purchased from a non-medical provider using rapid response testing strips. Test strips (TS) allow people who use illicit substances to be more informed about what they are buying and using, encouraging the adoption of harm reduction behavior measures. TS do not require a large amount of drug to effectively test and provide a result in 1-2 minutes. However, they do not provide information on how much of a substance is in a drug nor do they detect other drugs that may be present in a sample.
In addition to providing individuals with test strips and education on how to use them, they should also be equipped with other harm reduction resources and information on overdose prevention including the option to dispose of a fentanyl or xylazine-contaminated drug, providing education on how to use and inject in a manner that mitigates risks, ensuring that the medication naloxone is supplied to the individual and training on its use is provided. Naloxone does not reverse xylazine, however it will reverse the opioid present in the recreational drug.
While test strips should not be used as a systematic strategy to monitor all street drugs, it can be a powerful tool in helping providers educate and empower individuals how to approach uncertainty and potential unknown substances in their drug supply. When combined with overdose prevention training, test strips can be an effective harm reduction tool for both patients and providers. SAMHSA allows funding to be utilized to purchase and dispense harm reduction supplies such as test strips. Please visit Evaluation of Xylazine Test Strips (BTNX) for Drug Checking Purposes for additional information.
Thresholds Health New Westside Facility
In April, Chief Jones joined other local leaders and stakeholders at the opening of Thresholds Health in the Austin neighborhood on the Westside of Chicago. Thresholds Health is a full-service primary care health center specializing in the integration of primary, behavioral health, substance use care, and other needs! Thresholds Health welcomes all members of the Austin-area Chicago community, regardless of insurance status or ability to pay.
Healthcare Alternative Systems (HAS) New Westside Facility
In May, Chief Jones joined other local leaders and stakeholders at the opening of a new HAS facility in the Austin neighborhood on the Westside of Chicago. This new HAS facility provides a variety of services, including medicated-assisted recovery, counseling, and support services, as well as referrals to other necessary treatment programs. It also provides a safe and supportive environment for individuals and families to heal, grow, and move forward in their journey to recovery!
Coming to Light: A Path to Mental Health Services for All
In May, Chief Jones participated in a community conversation on mental health equity that was hosted by the wonderful team at the Kennedy Forum- Coming to Light: A Path to Mental Health Services for All. Chief Jones spoke on behavioral health integration, prevention, population health, treatment and connecting with social determinants of health. Also, he spoke to exploring comprehensive funding models.
Prairie State Mental Health Conference
In May, Chief Jones was honored to be selected as a keynote speaker at the 9 the annual Prairie State Mental Health Conference. This year's conference was centered around Post-COVID Realities in Mental Health. Chief Jones presented on how understanding individual, family and community strategies that contribute to wellness as we collectively emerge from the pandemic are essential. Moreover, he shared his thoughts on how creating pathways that facilitate long term sustained recovery from mental illness, substance use disorder or co-occurring disorders are the key.
The Kennedy Forum Upcoming 2023 Illinois Programs
The Kennedy Forum seeks to transform the way mental health and substance use disorders are treated in our health care system by advancing:
- Parity
- Quality & Transparency
- Integration
- Technology
- Brain
- Health & Fitness
- Youth Mental Health
Below you will find several upcoming programs the Kennedy Forum has planned for 2023. To receive updates and registration information about these upcoming programs, please sign up here. To get notifications when new video content is added, please subscribe to The Kennedy Forum Illinois YouTube channel. For any questions regarding the below programs, please contact Elizabeth.Evans@thekennedyforum.org.
May 30, 2023 (Webinar)
Hoops, Hurdles and Holdups: Navigating Private Insurance Coverage for Behavioral Health Providers
PANELISTS:
- Meiram Bendat, Attorney at Psych-Appeal
- Erica Weyhenmeyer, Illinois Department of Insurance, Assistant Deputy Director and Chief Market Conduct Examiner; Chair, National Association of Insurance Commissioners, Market Conduct Examination Guidelines Working Group
- Jud DeLoss, CEO, Illinois Association for Behavioral Healthcare
- David Lloyd, Chief Policy Officer, The Kennedy Forum, or Lauren Finke, Policy Director, The Kennedy Forum
Moderator: Joseph Feldman, MBA
June 1, 2023 (Print/Electronic Documents)
Mental Health Parity Law: Fact Sheet for Illinois State Legislators
Mental Health Parity Law: Key Concepts for Chicago City Council Members
Two legislative plain language guides to MH parity compliance. State guide will focus on reporting requirements for Illinois Department of Insurance and Illinois Department of Healthcare and Family Services, and information legislators need to evaluate reports.
The city guide will focus on Chicago's requirement to comply with MHPAEA by January 2024 following recent withdrawal of exemption for cities.
June 1, 2023 (Graphic Treatment/Exploration/Poster and/or Animation)
Boundaries in the Hybrid Workplace
Expert panel to generate guide for employers to design physical work environments to optimize mental health in an era of hybrid work.
Focus Group:
- Dr. Sally Augustin, Design Psychologist & Principal, Design with Science
- Taylor Adams, Director of Workplace Mental Health, Mental Health America
- Dr. Melba Nicholson Sullivan, People, Culture and Systems Consultant, Freedom Flow Solutions
- Alexi Robichaux, Co-Founder & CEO, BetterUp
- Kate Hayward, MHFA Instructor & Steering Committee Member, Mental Health in Recruitment
June 15, 2023 (Focus Group Leading to Online Report; Subsequent Survey for Publication in Trade Journals)
Mental Health Parity Law: Awareness for Clinicians
Clinician focus group on reimbursement:
- Clinician knowledge of and strategies for supporting diagnoses that avoid insurance denials
- Clinician's roles in the insurance reimbursement process
Conduct sentiment analysis, identify gaps in knowledge.
June 15, 2023 (Recorded Panel Discussion; YouTube Stream)
Finding Peace: Supporting the Mental Health Needs of our Veterans
PANELISTS:
- Brian Klassen, Clinical Director, Road Home Program, Rush University Medical Center
- Gregory Burek, MD, Co-Founder, Veteran's Program, Aurora Health
