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Moving Forward: Comprehensive Integrated Mental Health Plan, 2006-2011 

IV. Examples of Current Initiatives, Projects, and Activities That Fill Service Gaps

DHSS Priority Area: Substance Abuse

Comprehensive Fetal Alcohol Syndrome Project

Fetal alcohol spectrum disorders (FASD) are one of the most common causes of mental retardation and the only cause that is entirely preventable. FASD refers to those conditions caused by prenatal exposure to alcohol, including fetal alcohol syndrome (FAS). 

FAS is a medical diagnosis defined by the presence of specific growth and nervous system abnormalities and other factors. Receiving an early, comprehensive diagnosis that looks at growth deficiencies, facial dysmorphology, central nervous system functionality and maternal history of alcohol abuse provides a complete picture of the level of disability, the impaired functionality, and the overall interventions and accommodations that will benefit the individual. This is the first and most important intervention—from a comprehensive diagnosis, a clear case plan can be implemented and service delivery needs can be better coordinated.

FASD is found among all races and all socio-economic groups – wherever women drink alcohol, FASD can exist. With the right diagnosis, support and understanding, many individuals with FASD can live happy and full lives.

Alaska’s Comprehensive Fetal Alcohol Syndrome Project, is an example of an effort to prevent a developmental disability, to improve services for individuals with an alcohol-related disability and to enhance alcohol treatment services for women at risk of drinking alcohol during pregnancy. With state and federal funds, the Alaska FAS Project developed community-based teams that diagnose and refer children for services, developed a multimedia public education campaign to raise awareness about the danger of drinking alcohol during pregnancy, and improved training for all service providers in Alaska to better understand and serve affected individuals and their families. Alaska’s FAS Project has enhanced the state’s surveillance of alcohol-related births; thereby improving the state’s data related to FAS prevalence rates.

Recent Accomplishments

  • Recent data released by the Alaska Birth Defects Registry indicates that FAS birth prevalence in Alaska declined by 32% during 1996-2002.  (Children are often not identified and reported as FAS/D until around age six, when they are entering school; this is why 2002 is the most recent birth year reported.) The FAS birth prevalence declined by almost 50% among Alaska Natives.  This data suggests that the FAS prevention efforts started by the Office of FAS and continued by the Behavioral Health Office of Prevention and Early Intervention have made an impact in reducing the incidence of FAS in the Alaska population. For data, see Comp MH Plan Figure HA-4.
  • A new diagnostic team has recently been established in Anchorage to serve residents in Anchorage and outlying communities.  ASSETS, Inc. of Anchorage will begin offering diagnostic services to the Anchorage area in March of 2010.  The presence of the new team in Anchorage will significantly increase the State of Alaska’s diagnostic capacity for FAS.      
  • Alaska’s 3-M Project of Modeling, Mentoring, and Monitoring for Alaskan youth with an FASD has increased in capacity in the last year.  In the last year, they have recruited many new providers in communities throughout Alaska and have offered comprehensive, wrap-around training to those providers on topics related to FASD.  It is expected that enrollment in the 3-M Waiver Project will increase in the coming year.

Recent Challenges

  • There continues to be a lack of services for individuals with an FASD after they receive their diagnosis.  These clients often do not meet qualifications for services through Developmental Disability, while other social services are not structured in a way that accommodates the needs of those with an FASD.  Expansion of specialized FASD services would reduce the number of individuals with FASD entering the criminal justice system, the inpatient mental health system and other emergency based services; all of which are very costly to the State of Alaska.
  • While training around FASD has expanded in the last year, there continues to be a lack of appropriate training in how to most effectively work with individuals who live with a FASD.  The Behavioral Health Office of Prevention and Early Intervention has addressed this need with the development of FASD 101 and FASD 201 training.  At this time, over 60 Alaskans are trained to provide the FASD 101 training in their communities.  By April of 2010, the State will begin training trainers in the use of the newly revised FASD 201 training.  While this training offers providers an introduction to effective processes of supporting those with an FASD, more intensive, role-specific training is needed for social service professionals throughout the state.  The development and delivery of this training would increase providers’ efficacy in offering accommodations to people with an FASD, thereby lowering service costs and recidivism. 
  • FAS is 100% preventable when a women refrains from drinking during pregnancy.  Despite this fact, there continues to be a notable lack of needed substance abuse treatment services for pregnant women who suffer from chronic alcoholism.  Environmental strategies for FASD prevention, such as public service announcements and brochures in doctor’s office will not help these women.  They need intensive substance abuse treatment.  Currently, the Advisory Board on Alcoholism and Drug Abuse and the Division of Behavioral Health are addressing this need by putting forth an increment for the FY 2011 budget that would increase funding for substance abuse treatment for pregnant women.  While the placement and disbursement of this increment would help in the effort of offering support to this population, more funding is needed to adequately prevent FASD.     

Rural Substance Abuse Prevention

The Alaska Department of Health and Social Services Division of Behavioral Health was awarded a five-year grant from the Substance Abuse and Mental Health Services Administration (SAMSHA) Strategic Prevention Framework State Incentive Grant (SPF SIG) program. The grant targets rural Alaska’s ability to promote communities’ behavioral health – a term that includes both mental health and substance abuse prevention.

The Behavioral Health Division and its partners will develop more than a dozen regional training and support teams to serve the 200-plus villages and communities in remote Alaska. The grant will give the smallest communities an unprecedented opportunity to build on their strengths and use prevention strategies that have been researched and found to be successful in Alaska.

Due to the SAMHSA grant requirements, the first year will be spent analyzing data and resources to develop a statewide rural substance abuse prevention plan; once completed, grant funds will then be available to communities. To build the prevention plan, the Division of Behavioral Health, Prevention and Early Intervention Services section will work with Tribal and health organizations, other state agencies, schools, private non-profits, the University of Alaska, and others.

The Strategic Prevention Framework State Incentive Grant (SPF SIG) program provides funding to States and federally recognized Tribes and Tribal organizations to implement SAMHSA's Strategic Prevention Framework in order to:

  • prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking;
  • reduce substance abuse-related problems in communities, and
  • build prevention capacity and infrastructure at the State/Tribal and community levels.

The Strategic Prevention Framework is built on a community-based risk and protective factors approach to prevention and a series of guiding principles that can be operationalized at the Federal, State/Tribal and community levels.

Other Examples of Current Initiatives, Projects, and Activities That Fill Service Gaps

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