Spotlight on Richmond University Medical Center (RUMC)
In 2017, Richmond University Medical Center (RUMC) of Staten Island made it a priority to address the high percentage of people with behavioral health issues who also use tobacco. RUMC was aware that of the 480,000 people who die from tobacco-related disease every year, almost half are individuals with mental health and substance use disorders, and that those with serious mental illness smoke at three times the rate of the general population. Under the determined leadership of Michael Matthews, LCSW Director of RUMC’s outpatient behavioral health clinics, RUMC began taking steps to implement treatment for tobacco use disorders in their OMH-licensed and OASAS-certified programs located at the Center for Integrative Behavioral Medicine at 1130 South Avenue. As part of their strategy, RUMC engaged with NYC TCTTAC for training and technical supports.
RUMC sent 17 staff members to training and participated in various technical assistance activities, including webinars, online meetings, and in-person and telephone consultations – and they continue to engage with TCTTAC’s training and technical assistance to date. RUMC also developed a workgroup dedicated to implementing treatment for tobacco use disorder with a designated champion to oversee this work. The workgroup developed the following written vision statement:
RUMC also took action to produce a written plan to implement several components of treatment for tobacco use disorder. They held a health fair for people who smoke on tobacco dependence treatment where over 40 people expressed interest in working on reducing or quitting their tobacco use. They have implemented stage-appropriate groups for treating tobacco use disorder, and have incorporated carbon-monoxide monitoring into treatment. They have also worked to ensure that prescribing clinicians are knowledgeable and comfortable with prescribing nicotine replacement therapies (NRTs) and other medications used to treat tobacco use disorder. In September 2018, tobacco dependence treatment was introduced at another RUMC outpatient OMH clinic at 690 Castelton Avenue.
The RUMC workgroup meets regularly to celebrate successes and to brainstorm solutions to the challenges of addressing tobacco use. Future plans include continuing to educate staff through continuing education activities and introducing tobacco treatment options during the intake process.
On 10/2/18 RUMC presented a poster at the Staten Island Performing Provider System (SIPPS) Learning Symposium that detailed their approach to treating tobacco use disorders. They were awarded first place for this presentation! The main message of the poster was that it is not enough to simply encourage people to quit, and that providers must also understand tobacco dependence is an addiction that requires treatment.
Furthermore, RUMC’s outpatient clinics will incorporate tobacco dependence treatment into their mental health awareness month activities in May 2019. Staff will provide handouts and education to increase awareness on how mental health symptoms have a direct impact on tobacco use, and how smoking is often used as method of coping with stress.
Other lessons learned include the importance of working with people who are in the contemplation stage of change, using the harm reduction model, and how people who smoke anxieties about failing to quit can prevent them from joining tobacco treatment groups.
In order to help others starting this work in their own agencies, the RUMC workgroup, led by Randi Davis, is willing and enthusiastic to share more about their successes, challenges, and solutions for implementing tobacco treatment. If you would like to follow up, please contact Randi at email@example.com
Why is it important to treat tobacco use in the behavioral health population?
How did you implement treatment of tobacco use in your program?
How did incorporating treatment for tobacco use impact staff?