Congratulations to Adrienne Lapidos, Ph.D., clinical assistant professor in the Department of Psychiatry with Michigan Medicine, who is the 2020 recipient of the University of Michigan Depression Center's Eisenberg Collaborative Innovation Fund award, for a project entitled “The Peer Oral Health Initiative.” She is collaborating on this project with Danielle Rulli, RDH, MS, DHSc, clinical assistant professor of dentistry in the U-M School of Dentistry.
The Eisenberg Collaborative Innovation Fund award supports U-M faculty who are implementing and evaluating mental health services that promote integrated care and seek to improve access to evidence-based practices for lower income and Medicaid-eligible populations with behavioral health care needs in the state of Michigan. Dr. Lapidos’ and Dr. Rulli’s project “The Peer Oral Health Initiative - Developing and Testing a Brief Intervention Model” also received funding from the Delta Dental Foundation. Combined, the grants total more than $99,000.
The Peer Oral Health Initiative project will start in fall 2020. The link between oral health and psychological wellbeing is clearly established. But oral health remains a significant area of inequity for individuals with psychiatric disabilities, especially those who obtain services from Community Mental Health (CMH) and who are insured by Medicaid.
Individuals with psychiatric disabilities have greater oral disease risks and greater oral treatment needs than the general population. For example, the “dry mouth” side-effects of many psychotropic medications put individuals with psychiatric disabilities at risk for oral diseases, requiring special self-care and treatment approaches. Yet despite this heightened need, individuals with psychiatric disabilities often lack knowledge about preventive home-care behaviors, have access barriers related to social determinants of health (SDOH), have limited understanding of their own dental benefits, and often do not know how to find dentists.
One area of great promise to bridge gaps created by lack of oral health knowledge and SDOH among psychiatric consumers is the work of Certified Peer Support Specialists (CPSSs). In Michigan, these frontline community health workers are individuals who have obtained treatment for a psychiatric diagnosis from the public mental health system, and who have been trained and certified by the state to serve others with similar experiences. CPSSs provide outreach and support in CMH settings, and are Medicaid billable. Research evidence shows that CPSS-delivered interventions can be effective for managing physical health conditions. Drs. Lapidos and Rulli will apply this evidence to an oral health context.
The Peer Oral Health Initiative will take place at three CPSS-run drop-in centers in Michigan, all of which serve Medicaid-insured individuals with psychiatric disabilities. The initiative has three pillars: outreach, education, and linkages.
In the outreach pillar, CPSSs will roll out a public health campaign to identify and engage Medicaid-insured individuals with psychiatric disabilities who may have high oral health needs. In the education pillar, evidence-based practices will be adapted to launch a CPSS-delivered brief intervention and referral to treatment model that is designed to improve oral health knowledge, self-care behaviors, and healthcare utilization. Drs. Lapidos and Rulli will work with McMillen Health to develop tailored health education materials for use by peers. In the linkages pillar, CPSSs will provide warm handoffs to local dental clinics and will follow up to ensure appointments are completed. Awareness of scope of practice is important to this initiative. Drs. Lapidos and Rulli will not be training CPSSs to take on the roles more appropriate for dental professionals. Rather, they will carefully select oral health home-care topics that can be shared with patients within the CPSS scope of practice, and will carefully manualize the brief intervention to ensure fidelity and consistency of information shared.
About Dr. Lapidos: Adrienne Lapidos is a Clinical Assistant Professor at the University of Michigan Medical School, Department of Psychiatry, and is a member of the University of Michigan Depression Center and Institute for Healthcare Policy and Innovation. Her research focuses on innovations designed to improve access to care, especially novel interventions led by Community Health Workers that integrate physical, behavioral, and oral health. As a practicing clinical psychologist at Michigan Medicine, she works with individuals living with depression, psychosis, and post-traumatic stress.
About Dr. Rulli: Danielle Rulli has a passion for oral health, and has a wide range of experience from assisting, to clinical dental hygiene and expanded functions. Her undergraduate dental hygiene studies were completed at the University of Vermont in 2004, and in 2007 she received her Master of Science in Dental Hygiene Education from the University of North Carolina. She received her Doctor of Health Science degree in 2015 from Nova Southeastern University. In addition to being an educator, she has also worked at the American Dental Hygienists’ Association (ADHA) as the Manager of Student Relations. She is a member of ADHA, as well as the American Dental Education Association. Her research interests include interprofessional education/collaboration, clinical research, and alternative workforce models. She actively practices dental hygiene in the Graduate Periodontics clinic at the U-M School of Dentistry.