5. Admitted to the Office of Mental Health and Addiction Services (OMHAS) and the Oregon legislature that for the past 70 years, we've been running on sweat equity, imagination and rubber bands.
6. Grudgingly agreed to do some reading and to keep an open mind.
7. Swore all the way to the dumpster with our favorite handouts and films.
8. Made a list of all the practices that made sense to us and became willing to check at least some of them out.
9. Agreed to learn one new thing this year as long as it didn't add to our caseloads or paperwork.
10. Continued to work on doing the impossible with no new resources and dreamed of deleting databases when no one was looking.
11. Sought through outcomes data and specific serotonin reuptake inhibitors (SSRIs) medication to improve our conscious contact with the legislature, praying only to prove that treatment works and we're truly not sleeping at our desks.
12. Having had a rude awakening as the result of these steps, we vowed to share our retention data with programs that were still pre-contemplative and to practice fidelity in all of our affairs.
By Bonnie Malek, MS, QMHP III, CDS III
E-mail : firstname.lastname@example.org
* Overview of Oregon Senate Bill 267
The 2003 Legislature passed ORS 182.525 (Senate Bill 267). This bill requires that increasing amounts of Oregon state funds be focused on Evidence-Based Practices (EBP). For 2005-07, the statute requires that at least 25 percent of state funds used to treat people with substance abuse problems who have a propensity to commit crimes be used for the provision of Evidence-Based Practices. The statute also requires that 25 percent of state fund be used to treat people with mental illness who use or have a propensity to use emergency mental health services. In 2007-09, the percentage of funds to be spent on EBPs increases to 50 percent and in 2009-2011 to 75 percent.
The shift to the delivery of services based on scientific evidence of effectiveness is a major shift for both the mental health and addiction treatment systems. This shift includes a focus on lifelong recovery for person with mental illness as well as those with substance abuse disorders.
As part of an effort to meet requirements outlined in ORS 182.525 (Senate Bill 267) from the 2003 Legislative Session, the Office of Mental Health and Addiction Services (OMHAS) developed an operational definition of evidence-based practices. The definition was developed with broad community input before being officially adopted by the office.
Your September '07 Tips & Topics focus on rote documentation to please the overseers was dead on. The issue to me seems to be to look at the purpose of any particular paperwork and how is it facilitating patient care. Often in site visits I'll come upon a form or some other sort of spurious documentation and ask "What's it for" and be told, "Don't know. On our last survey they said to do it so we just do it and they don't bother us about that anymore." I started calling this superstitious documentation.
Once on a bike ride I noticed some baggies of water stapled to the rafters of a porch at a rural store. I was staring up at them and the owner came out and I asked, "What are those for?" He replied, "Keeps the flies away." I asked how. He responded: "We don't know, but it works." "Earl has some at his BBQ and they don't never get pestered by 'em, so we put 'em up."
I think putting up baggies of water is what many of us as treatment providers are doing in our documentation in order to keep the flies away, or in our case, not be pestered by surveyors. Hanging baggies of water and filling out meaningless forms both seem to qualify as superstitious behaviors. Then again, maybe not as they are both effective in keeping the flies away.
Bill Garrett, MPH
Shoals Treatment Center
Muscle Shoals, Alabama