IACP 2014 POLICE PSYCHOLOGICAL SERVICES SECTION First Responder ADDICTION TREATMENT SUBSTANCE ABUSE PREVENTION James Nestor MAS, CEAP, LCADC Director Office of Employee & Organization Development New Jersey State Police / Office of the Attorney General
Superintendent Joseph Rick Fuentes is committed to leadership that presents the highest quality of professional public service by the NJSP Trooper. He will demand the high moral road in dealing with the members behaviors and actions, and is dedicated to assisting all his employees, with whatever support is needed, in driving the Division toward its mission. When critical incidents cause need for environmental evaluation, his response is to qualify and quantify the changes needed to enhance the core values that direct the NJSP vision.
NEW STRATEGIES Awareness & Prevention Academy Recruit Training 2-Year Reenlistment 4-Year Reenlistment All Supervisory In-service Training (Sgt., SFC, Lt., Executive ) Division-wide In Service Training Supervisory Referrals OPS Alcohol Related Complaints: Mandatory Referral Policy Revision Medical Disease Monitoring
SERVICES
JOB PERFORMANCE Supervisor s Responsibility Supervisor Consultations Co-worker Consultations Preventative Training Fitness for Duty to Medical Services
The Department of Law and Public Safety recognizes the value and importance of providing organizational and management assistance for issues that affect the leadership and productivity of the organization. Our Mission is to provide all levels of management with a wide range of consultative and training services that will enhance and develop management skills resulting in a more productive, healthy workplace and support the overall Mission. What is OEOD s Management & Organization Services? Professionals possessing a broad range of formal education and training in business, human behavior, and consultative techniques, who are also knowledgeable about the mission, policies, procedures and culture of the Division of State Police. Our management services are committed to collaborating with managers and employees within the organization to bring about positive change through the use of process-based interventions. We pride ourselves on being a confidential service that designs interventions to meet the specific needs of our clients. Management Consultation Team Assessment Leadership Awareness Conflict Mediation Focus Groups Team Development Management Coaching Workplace Trends
REFERRAL TYPES Self Supervisory Mandatory Domestic Violence Critical Incidents Performance Appraisals Violence in the Workplace Other ( Medical / Peer Contact / HRM / Union )
POLICE PERSONALITY TRAITS S T J s Locus of Control Internal External Optimism vs. Pessimism (+) Serotonin (-) Serotonin Healthy Depression
EAP s Duty to the Individual and the Department
TYPES OF PROBLEMS Psych/ Emotional 13% Domestic Incidents 5% Substance Abuse 6% Marital & Family 31% Critical Incidents 23% Work Related 22%
SCREENING/TESTING USED to DIAGNOSE ALCOHOL ISSUES Blood Alcohol Tests Red Blood Cells: Mean Corpuscular Volume (MCV) Liver Function Tests (LFT)
First time DWI charge or other alcohol-related offense: S w/o P, Rehabilitation and Career Probation Second alcohol-related offense, regardless of other factors: S w/o P, Adjudication, Move to Terminate First time DWI offense involving accident with injuries: S w/o P, Adjudication, Move to Terminate First time offense of DWI with candor / falsification of record: S w/o P, Adjudication, Move to Terminate First time offense of DWI accident with leaving the scene: S w/o P, Adjudication, Move to Terminate
Alcohol Consumption in the United States Subpopulations of Drinkers in the U.S. Non- Drinkers Sensible Drinkers Transitional & Problem Drinkers Severely Dependent or Alcoholic 25% of Adults (No Problems) 40% (Avoid Problems) 25% + (Several Problems) 10% (Many Problems)
WHAT IS MODERATE DRINKING? The meaning of the term moderate is highly subjective. What one person considers moderate drinking, another person may consider heavy drinking (Dufour, 1999) DHHS defines moderate drinking as no more than 1 drink a day for most women and no more than 2 drinks a day for most men. A standard drink is 12 oz of beer; 5 oz of wine or 1.5 ounces of 80 proof distilled spirits. (.5 ounce or 12 grams of absolute alcohol) Average Alcohol Content (Dorenberg & Stinson, 1985) Beer 4.5 % alcohol Wine 12.9 % alcohol Spirits 41.1 % alcohol
ACCOUNTABLE CARE IS Prevention Care Team Coordination Electronic records Proven Treatment 24/7 Access
ACOs Contract w/health Plans Measure and report on quality care Focus on Preventive Care Team Coordination Continuity
ACCOUNTABLE CARE INTEGRATION Transitioning traditionally siloed care systems into seamlessly collaborating systems of care is a complex change process. Early adopters of integrated substance abuse and primary care have achieved successes Recognize that healthcare is no longer provider-centric; it is person-centered To succeed in providing integrated healthcare, the entire organization must embrace this philosophy as it is central to the current and future healthcare marketplace
MATCHING TREATMENT WITH THE INDIVIDUAL S NEEDS No single treatment is appropriate for all individuals Effective treatment attends to multiple needs of the individual, not just his or her drug use Treatment must address medical, psychological, social, vocational, and legal problems = MULTI-SYSTEMIC AND MULTI-MODAL
CHOOSE THE LEVEL OF CARE ASAM Patient Placement Criteria 2 nd Edition PPC-2
SO Treatment must be medically & scientifically driven: Show me the research! Drug-free treatment is appropriate at a specific developmental stages of recovery for some, but not all, patients Condemning patients who are ETOH patients is stigmatizing and does not promote recovery There is no debate let s respect the humanness of people suffering and treat them Cut the person a break
WHAT THE TREATMENT COMMUNITY NEEDS TO DO: LONG-TERM GOALS Foster a Learning Culture Be Organized Be Predictable Measure Outcomes Communicate with Other Agencies Base Treatment on Evidence and A Guide/Process Approach Integrate Services
HOW LONG SHOULD LAST? Depends on patient problems/needs Less than 90 days is of limited or no effectiveness for residential/outpatient 18 month behaviorhealth change process Longer treatment is often indicated DISEASE of Maintenance Lifelong COMMITMENT
FORENSIC ASSESSMENT On-site Psych/Socio/Bio History SASSI III 12 Panel Drug Screen and Breathalyzer Lab Conformation (Hair testing) Collateral Sources Work, friend, parent/sibling PCP / Pharmacy / EAP / Dept. Dr. Significant other questionairre Reports, legal matters, complaints (physical docs)
PSYCHOLOGICAL EVALUATION Clinical Evaluation PTSD Instrument ( TSI / DAPS ) Family and Workplace contact EAP assessments (DV, CIS)
INTEGRATED CONTINUUM OF Tx Medical Detox Treatment Continuous Medical Monitoring Inpatient Residential Programs Partial Hospitalization Day Programs Outpatient Programs 3 mos. FRAT Continuum of Aftercare Family & Couples Therapy Family Support Groups Return to Work Services Chaplain Services
MEDICATIONS Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. Alcohol: Opiates: Nicotine: Naltrexone / Vivitrol Naltrexone, Methadone, Buprenorphine Nicotine replacement (gum, patches, spray, inhaler)
PEER SERVICES Peer Recovery Outreach Peer Support Focus Groups First Responder Alumni 12-Step Meetings Peer Training Alumni Peer Opportunities Sober Events for 1 st Responders and Families
SUBSTANCE ABUSE PREVENTION FOR FIRST RESPONDER S
ESTABLISHING QUALITY BENCHMARKS Important to ensure national standardization of quality benchmarks and how they are interpreted and reported Will also have to be applicable to variety of care providers and care settings that can be included in an ACO Combination of process, outcome and patient experience measures TRI / LF- Relapse Prevention Project
3 YEAR DATA OVERSIGHT - FRAT (450) 1 st Responders Tx 80 relapse w/ less than 90 continuous I/OP Begin to monitor SA Prevention Project
JIM NESTOR MAS, CEAP, LCADC Administrator jnestor@livengrin.org