NorthKey’s program uses the CCBHC integrated care model. This means that NorthKey recognizes the interconnectedness of a person’s medical/physical health and behavioral health. Smoking or other forms of tobacco use can lead to a tobacco use disorder in which an individual experiences distress in a number of ways as a result of using the substance. This includes physical, emotional, and behavioral symptoms. While a person living with behavioral health challenges may begin to smoke or use tobacco in hopes to reduce stress and anxiety, the relief is only temporary. In addition, nicotine products are addictive and come with a number of serious health risks. A person who is working to stop smoking or using tobacco may experience some symptoms such as increased irritability and anxiety. However, these symptoms will subside.
This work builds on the foundation of tobacco control work that has been growing over the past four years at NorthKey through a partnership with the University of Kentucky College of Nursing’s Behavioral Health Wellness Environments for Living and Learning (BH WELL) research team. Initially, they partnered to complete a tobacco policy and use survey of NorthKey programs. Following this work, BH WELL provided education, training and tobacco treatment specialist (TTS) scholarships to NorthKey.
CCBHC Project Director Christy McGovern shares, “The value of having tobacco treatment trained specialists is that we can and have used the knowledge and skills acquired through the TTS training as a launchpad for continued growth in this area for our whole organization. Our staff who have taken the TTS training are much more informed and able to assist clients who smoke or use tobacco.” Christy also shared that the TTS training prepared employees to feel more comfortable initiating conversations with clients about tobacco use and made them more aware of the pharmacological treatments available to those interested in quitting. The training taught participants how to navigate online resources to ensure use of reliable sources of information.
One of the NorthKey TTS’s, Liz Bullock, used what she learned through the training to develop and lead a NorthKey training for other team members. The training educated staff on assessment, treatment planning, and therapeutic interventions for tobacco use with a focus on cognitive behavioral therapy and motivational interviewing. NorthKey TTS’s will serve as internal experts as they continue to train staff across all NorthKey programs to integrate tobacco treatment into the client’s person-centered recovery plan.
NorthKey’s Tobacco Treatment subcommittee has focused on a number of areas over the past year. These include putting measures in place to increase tobacco screening and tobacco treatment interventions across the organization, tracking data on the number of NorthKey clients who report smoking and the number of tobacco screenings and interventions administered across time, and education for clients and staff. Liz Bullock worked alongside Primary Care APRN, Kelli Koors, to develop and lead a training on pharmacological interventions for tobacco cessation.
NorthKey TTS incorporate tools from their training into individual client treatment offerings. Their Primary Care and Psychiatric Medication providers and Integrated Care Coordination team members screen clients for tobacco use during their initial visit, annually, and intermittently as appropriate. This includes using the 5 A’s of tobacco cessation: Ask, Advise, Assess, Assist, and Arrange. NorthKey also offers a monthly virtual Tobacco Education 101 class to clients led by a NorthKey Prevention team member. This class provides information about the various forms of tobacco, the impact tobacco use has on individuals and communities, and resources for quitting. They encourage clients who participate in Therapeutic Rehabilitation, Intensive Outpatient Program, and substance use groups to attend this class.
BH WELL is grateful to have NorthKey Community Care as a partner who shares a vision to aiding individuals living with mental illnesses in stopping tobacco use. NorthKey was supported by BH WELL scholarships for their team members to complete the University of Kentucky College of Nursing’s TTS training. This program is housed within the BREATHE research team and is led by Dr. Audrey Darville.
Funding for the TTS scholarships was provided to BH WELL by the Kentucky Department for Public Health’s Tobacco Prevention and Cessation Program.