Inching toward health and wellness for those with the greatest need: Chronic disease prevention in mental health and substance abuse recovery communities

Client-centered service delivery has led to advances in mental health and substance abuse recovery. However, people living with mental illness are estimated to die 25 fewer years before the general population. The San Mateo County Tobacco Prevention Program has partnered with Behavioral Health and Recovery Services to address this disparity.

Efforts have focused on collecting and analyzing local data, dialoguing with all involved parties, and developing lasting systems change within the County. The project developed a focus group protocol for consumers and a survey for clinicians. Focus groups showed many consumers willing to quit and looking for support. The survey results exhibited clinician anxiety and lack of knowledge regarding tobacco addiction.

Despite this being a sensitive issue that is potentially stigmatizing to consumers, we are seeing movement. Discussion has taken place through newsletter articles and a fact sheet sharing consumer quitting experiences and the impacts of tobacco on the mental health community. Trainings have been conducted for clinicians to help consumers quit, for asking-advising-referring smokers, and another peer-to-peer consumer quitting training. Staff approached many consumer and clinician groups including a clubhouse, local NAMI, and Board & Care housing administrators.

The goal of the project has been to implement lasting systems change. This has been partially accomplished to date through implementation of cessation classes, the rollout of a new smoke-free campus policy, and a policy paper that highlights the importance of ensuring better quality of life in recovery. Next steps include social marketing and celebration of wins.