Our white papers communicate research, theories, and our position on particular topics connected to our mission and vision, with the intent to educate, inform, and influence policy.
The Future of Behavioral Health Care: Addressing Behavioral Health Needs and Solutions at the Federal Level (2023)
Navigating through the aftermath of the COVID-19 pandemic calls for a nimble, creative and robust redesign of funding mechanisms and associated policies to invest in the United States’ behavioral healthcare system. This paper identifies significant and high-potential opportunities to expand quality integrated health care through community behavioral health organizations. Five strategic areas briefly discussed as key opportunities and crucial areas needing a revision of funding mechanisms and policies are: school-based behavioral health services, integrated care behavioral and medical health care, federal funding restrictions and limitations, commercial insurance and parity, and social determinants of health. By leveraging the impact and innovation of non-profit community-based mental health providers, such as OhioGuidestone, federal funding can be used more responsibly to create opportunities for communities and empower providers to serve their clients with high-level, integrated care. Amid the turmoil, the COVID-19 pandemic has provided us an opportunity to scrutinize our current systems and rebuild them, first and foremost, to meet the needs of individuals, families, and whole communities.
Humble Before the Culture: The Power of Immersive, Ongoing Multicultural Learning for Behavioral Health Professionals (2021)
Cultural humility — whether seen as the foundation of cultural competence or the garden in which cross-cultural relationships grow — is necessary for all behavioral health providers. It is closely entwined with trauma-informed care and therapeutic alliance, as vital keys to unlocking the best possible patient outcomes. Thus, healthcare organizations of all stripes should not merely make cultural humility a type of program or component of their training, but infuse it into every aspect of their operations. A desire to learn and an attitude of respect toward all the many intersecting cultures will enhance care and benefit both clinician and client, particularly those in underserved or marginalized communities.
An Evolution of Substance Use and Mental Health Treatment: The Post-Pandemic Need for Technological Change (2021)
Substance use disorder and mental health treatment via telehealth has abruptly become a necessary means of health care delivery during the COVID-19 pandemic. Meanwhile, substance use disorder is on the rise, likely due in part by the social isolation and added stress of the pandemic. Thus, in order to respond adequately to the need for substance use disorder treatment, telehealth options are a must for clients. While the technological ability for providers to reach clients remotely can potentially make an extreme impact moving forward, clients need reliable and consistent access to the internet for telehealth to work effectively.
The Danger of Misusing Prevention Data: Resisting Pathologization and Hypersurveillance in Behavioral Health Screenings Through Trauma-Informed, Community-Centered Prevention Strategies (2021)
Behavioral health screenings, such as for adverse childhood experiences, are important data for identifying individuals and communities at risk of long-term ill health effects. However, without a framework that centers the desires and needs of the people who are screened and a trauma-informed lens, we risk pathologizing people and subjecting them to surveillance that can be harmful and intrusive. By carefully using prevention data to empower people to make decisions for themselves and their communities, we can enhance our care and public health through mutuality and collaboration.
Epigenetics, which looks at heritable changes to gene function that occur “over and above” changes to the DNA sequence, is a growing field of study that healthcare providers, educators, researchers, and policymakers all should be knowledgeable of. Because of how epigenetic modifications can alter gene expression through generations, researchers are uncovering important connections to health and disease, including behavioral health and psychiatric disorders. We also are learning that these modifications sometimes may be driven by such factors as social determinants, physical environments, and stress.
As one of Ohio’s leading behavioral health providers, OhioGuidestone is taking the lead on promoting, educating, and responding to issues that may affect or be affected by epigenetics as they relate to our clients, their families, and their communities.
Preventing Harm and Deaths from Racism and Poverty: The Need to Eradicate Sources of Toxic Stress in Communities to Improve Public Health (2021)
Racism and poverty are two major drivers of toxic stress, which harms families and communities across the United States. This stress can lead to a large number of adverse health effects and outcomes, particularly in children, causing long-term health issues and even reducing life expectancy.
As one of Ohio’s largest behavioral health agencies, OhioGuidestone recognizes our commitment to the families and communities we serve and the need to eliminate sources of toxic stress in their lives as a preventative public health goal. We call on health providers and public policymakers in all fields to address the interconnected systemic inequities and injustices of racism and poverty that harm the people we are dedicated to serve.
For health and wellness to flourish, racism and poverty both must be eliminated.
Addressing ACEs by Closing the Divide between Community Mental Health and Primary Care Screening: Training, Innovation, and Local Primary Care Partnerships (2020)
This white paper brief offers a glimpse of OhioGuidestone’s commitment to addressing ACEs through innovation and community partnerships. Namely, OhioGuidestone’s partnership with local primary care clinics to screen and respond to ACEs in children and pregnant women is featured.
OhioGuidestone’s experience integrating ACEs screening and referrals with primary care screening and treatment demonstrates its unique qualification to up-scale such efforts in other primary care settings in Ohio.
Statewide Demonstration of the Effectiveness of Mental Healthcare via Telehealth Required Before New Rules and Presentation of “An Algorithm of Tele-Mental Health Care” (2020)
In March 2020, health agencies coordinated with government officials throughout the U.S. to offer telehealth services during the COVID-19 pandemic. For mental health providers such as OhioGuidestone, this offers an opportunity to evaluate our services and continue to build client-centered approaches to care.
While telehealth can offer greater accessibility, even after emergency lockdown orders expire, we need to demonstrate the efficacy of services delivered via telecommunication, compare modes of delivery, and ensure clients and clinicians have necessary technological tools. Behavioral health experts can help guide researchers and policymakers toward evidence, evaluation, and implementation of expanded telehealth service delivery for mental health clients. This paper offers our preliminary experiences with expanded telehealth service, driving questions for research, and paths forward for future directions.
Push for PROMs: Patient-Reported Outcomes Are Necessary for Evidence-Based & Client-Centered Community Mental Health Treatment (2020)
Patient-reported outcome measures (PROMs) are useful tools for clinicians and researchers working in behavioral health fields, as well as for the clients they serve. These measures allow programs and treatment to be tailored carefully to the client’s needs and offer a necessary client-centered perspective for developing evidence-based practices. Therefore, we advocate for routine measurement and monitoring of patient-reported outcomes.
In this paper, we detail how OhioGuidestone has implemented and developed PROMs in community mental health treatment, what domains we focus on and why, which barriers to implementation have arisen and how we’ve addressed them, what goals organizations should keep in mind when implementing PROMs, and what implications for future treatment and research PROMs data can offer.
OhioGuidestone’s Impact on Ohio’s Health Value: A Response to HPIO Strategies to Improve Ohioans’ Health (2020)
In 2019, the Health Value Dashboard created by the Health Policy Institute of Ohio (HPIO) placed Ohio at 46th out of 51 in health value among U.S. states and the District of Columbia. Ohio’s low ranking was not due to lack of access to care, HPIO found. Instead, the policy group identified nine strategies that would help improve Ohio’s score and thereby improve health outcomes and quality of life for all Ohioans, particularly those most at risk due to disparities. These strategies target downstream care delivery systems rather than costly upstream care, including evidence-based home visiting, lead abatement, housing, public transportation, and investment in Ohio’s behavioral health workforce.
As one of Ohio’s largest behavioral health organizations and social service agencies, OhioGuidestone has investment in many of the strategies outlined by HPIO. Either through OhioGuidestone’s continuum of services or through innovations produced by its Institute of Family & Community Impact, we have an opportunity to be integral partners in efforts to improve Ohio’s health value—and thus help Ohio’s children, families, and communities grow stronger and healthier.
Lead Poisoning & Behavioral Health: Increased Referrals for Treatment Can Mitigate Long-term Consequences of Childhood Lead Poisoning (2020)
For decades, childhood lead poisoning has been a persistent problem in certain neighborhoods in Ohio, particularly putting at risk African-American children, children from impoverished families, and/or children living in older homes. The effects of lead poisoning in children can be wide-ranging and long-lasting, leading to a variety of health issues—including behavioral.
In this paper, we assert that it is necessary to mitigate the long-lasting consequences of lead poisoning by examining lead poisoning through a psychosocial lens, and include in its treatment the expansion of behavioral health treatments. We call for required referrals to behavioral health services for any children identified to have elevated blood lead levels.
“Just Try Harder” Doesn’t Heal: Addressing the Therapeutic Needs of Clients in Community Mental Health Treatment with Evidence-Based Innovation (2020)
Clients in community mental health treatment often face barriers and stress factors that limit the impact of treatment. Therapy-interfering conditions (TICs) such as housing, education, employment, and transportation are common unfulfilled needs for populations that utilize community mental health. Meanwhile, toxic stress and trauma often are heightened by clients’ contexts. Therapy, therefore, must take these factors into account in order to be effective and focus on clients’ basic needs—physical, social, and emotional—in addition to cognitive-behavioral treatments.
Cognitive behavioral therapy (CBT) alone may not be adequate in this admittedly gargantuan task. Instead, by addressing therapeutic needs with a matrix of upstream interventions, contextual training for mental health professionals, and innovative therapies such as the Institute of Family & Community Impact’s CBT Plus©, we have an opportunity to close disparity gaps in health, both psychological and physiological, and empower marginalized, underprivileged, and impoverished communities.
Expand Insurance Coverage of the PLAY Project to Support Developmental and Relationship-based Treatment of Young Ohioans with ASD (2020)
To treat autism spectrum disorder (ASD) in children, most clinical practices have focused on using a limited toolbox of behavior-targeting treatment modalities. Due to the nature of ASD and variance along its spectrum, individualized care may require a number of different techniques, which can be time consuming, costly, and overwhelming. In addition, some therapies that are more common in treatment—such as applied behavioral analysis (ABA)—may not be as effective for certain populations.
Parent-implemented models (PIM), such as the PLAY Project can offer an evidence-based ASD treatment that is cost-effective and flexible. PIMs intentionally engage and empower caregivers, which in turn positively impact results for children. Insurance coverage for the PLAY Project is an important component to gaining comprehensive care for young children with ASD.
Toxic stress occurs as a response to prolonged, adverse experiences without adequate adult support that impairs brain development and functioning. The 2016 National Survey of Children’s Health found that as many as 1 in 7 Ohio children had experienced three or more adverse childhood experiences (ACEs), higher than the national average. Childhood adversity often leads to toxic stress, which has multifaceted deleterious implications across a lifespan; however all hope is not lost. Children’s brains are highly susceptible to negative experiences, but are also strongly impacted by positive experiences as well, leaving opportunities to build adequate defenses against toxic stress.
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