A Comprehensive Training Model for Treating Tobacco Dependence in Mental Health Settings <bold>IMPLEMENTING A WELLNESS CURRICULUM ON TOBACCO TO ENGAGE SMOKERS WITH MENTAL ILLNESS - April 7, 2011 PRE-TEST</bold> Question Title * First Name Question Title * Last Name Question Title * Please check if your agency has the following practices or policies in effect with regard to addressing tobacco at this moment (answer each item Yes or No) Yes No Peer specialist delivered services that educate about tobacco, engage tobacco users into treatment or peers that provide tobacco treatment services Peer specialist delivered services that educate about tobacco, engage tobacco users into treatment or peers that provide tobacco treatment services Yes Peer specialist delivered services that educate about tobacco, engage tobacco users into treatment or peers that provide tobacco treatment services No Onsite clinical services to help tobacco users to quit (assessment, groups or individual counseling) Onsite clinical services to help tobacco users to quit (assessment, groups or individual counseling) Yes Onsite clinical services to help tobacco users to quit (assessment, groups or individual counseling) No Onsite access to a prescriber who helps tobacco users to quit by prescribing nicotine replacement or another tobacco treatment medications Onsite access to a prescriber who helps tobacco users to quit by prescribing nicotine replacement or another tobacco treatment medications Yes Onsite access to a prescriber who helps tobacco users to quit by prescribing nicotine replacement or another tobacco treatment medications No Written policies about tobacco that include tobacco dependence education and recovery options for clients? Written policies about tobacco that include tobacco dependence education and recovery options for clients? Yes Written policies about tobacco that include tobacco dependence education and recovery options for clients? No Written policies about tobacco that include tobacco dependence education and recovery options for staff? Written policies about tobacco that include tobacco dependence education and recovery options for staff? Yes Written policies about tobacco that include tobacco dependence education and recovery options for staff? No A specific policy that prohibits tobacco use, not only in buildings, but outside on all adjacent property? (tobacco-free grounds) A specific policy that prohibits tobacco use, not only in buildings, but outside on all adjacent property? (tobacco-free grounds) Yes A specific policy that prohibits tobacco use, not only in buildings, but outside on all adjacent property? (tobacco-free grounds) No Question Title * Does your agency have a Quality Improvement (QI) plan for addressing tobacco at this moment? Yes No Next
