Geagua County, OH
Planning -- The most effective strategy within a community for any public health issue is two-fold: education and focus. To accomplish this at the community level, there needs to be a broad level of focus and support from all levels of the government: local, State and Federal, in order for there to be a consistent and proactive message. Education should begin at the elementary school level, with teaching talking about substances, abuse and alternatives; and move through the school system as appropriate for the cognitive abilities of various age groups. In this way, the community can collaborate with schools to provide initiatives and programs that address the problem prior to it becoming as endemic, and offer proposed solutions in a way that almost everyone involved knows they can receive help if necessary. The educational process must also be pervasive and accessible -- people need a number to call for advice and help (Bangeret-Drowns, 1988).
Second, Geagua County clearly needs an ambulatory detoxification and abuse program in order to assist in the needs of individuals with substance addictions. This goes along with several national guidelines, many from individual State Department's of Human and Health Services. The overall plan for such a system is:
Developing a plan for the effective prevention of alcohol and drug abuse, particularly among youth.
Collaboration between public and private health care organizations and agencies to develop an effective community-based alcohol and drug abuse prevention and treatment program.
Promotion of treatment services to appropriately meet the needs of addicted citizens.
Identifying and ensuring compliance with unmet needs within a community-based system (DSHS NH Health and Human Services, 2010).
Interventions -- For the County of Geagua, there are two rather important needs to meet the requirements of an appropriate level substance abuse strategic model: Robust Educational Modeling and an Ambulatory Detoxification Program. These programs would be in addition to, and work with, the current programs of: 1) Diagnostic Assessment and Counseling; 2) Intensive Outpatient Program for Teens; 3) Prevention students that are provided to at risk youth (Pride, Red Ribbon and Teen); 4) Early Warming Program and 5) Services at Chagrin Falls Park for most of Northern Ohio (Geauga County Board of Mental Health, 2012).
Community Assets -- Resiliance is based on belief, and the only way community members will believe is if they see that something is being done, and then results. Resiliance could be improved by showing the community that partnership and education works on a multi-level, functioning manner. A social connection is multifold -- it requires the Public Health Departments at the State and County level to work together to form initiatives that are effective and translate into the schools, into the Churchs (perhaps sponsoring an alternatives for at risk individuals), and through Youth Centers, Senior Centers, hospitals, medical clincs, and transportation services. The more synergetic the system becomes, the deeper it will be part of the community. Change is not easy in any community, and supporting change in substance abuse programs, for instance, to provide more healthy alternatives, will pressure the political and social systems as well, resulting in scaling change in a rather incremental level (Roots of Change, 2012) (Scaling Change, 2012). It will be necessary to form multilevel partnerships within the community, as shown above, that are synergistic, robust, and active. We can envision them as a spoke and wheel concept, with each spoke representing part of the community and the hub the County government; also with ties to the State and Federal levels for funding, information, and services:
Figure 1 -- Synergistic Approach to Community Health
(See: National Institute on Alcohol Abuse and Alcoholism, 2005; Perkinson, R., et al., 2009).
Key Organizational Needs- Effective public administration implies that governmental policies are implemented in a fair and equitable manner that is positive for society. It must advance management principles so that government and governmental programs can function. There are a number of approaches that public administration can take: behavioral, systems, ecological, or contingency; and a number of theoretical options within each of these broader categories. Systems approaches look towards the functional integration of different stakeholders and their goals towards a specific issue or path. What implications might a proposed solution have and to what groups? What is the functional relationship between groups of stakeholders and how can that be maximized. For substance abusers, this approach looks at ways to construct programs that are utilitarian in context (the greatest good for the greatest number) (Berkowitz, M., et al., 1991).
Often, we find that health promotion programs lack a clearly specified theoretical focus...
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