Mental Health Participant Pet Veterinary Care: The community feedback period for this idea began on 1/16/2019 and ended on 3/17/2019. *STATUS UPDATE*

What is the problem that needs to be addressed? Please describe how it is related to mental health.

Veterinary Care for pets – specifically dogs – owned by people experiencing mental illness / homelessness. People experiencing mental illness / homelessness many times are alone and consider a pet such as a dog as their only family. Pets are typically not allowed in homeless facilities unless the pet is a service animal (very expensive). Pets are also vectors of disease to humans.

 

Why is this a concern for Orange County? What can Orange County and other counties learn from this project?

Pets are a vector of disease to humans especially when veterinary care is not utilized. While mental illness has treatments, dog worms that track into the human liver, eye, brain or lungs can cause irreversable damage. A person with mental illness can achieve activities of daily living and advanced activities of daily living without excessive assistance. A person who is blind, has permanent brain injury, has hepatitis, etc may require highly expensive assistance or healthcare interventions.

 

What is currently being done to resolve this problem in our county and throughout the United States? If applicable: Is it working; why or why not?

Orange County currently does not treat dogs owned by people experiencing mental illness / homeless. Vital development data, such as morbidity and mortality caused by the dog vector, is unknown.`

 

What is new or different about this project idea? Please describe how this differs from what is already being done (Question 6). Please list any research that was done on this topic.

https://www.cdc.gov/healthypets/pets/dogs.html The CDC cites roundworm as a common disease that can progress to invove human lungs, liver, brain and eye. Please see the CDC website for many other diseases with pet dogs as a vector to humans.

 

What is the project idea? Please describe how this project will operate.

Provide veterinary services to dogs owned by people experiencing homelessness/mental illness. It is likely that treating the dog is less expensive than treating the human disease.

 

Additional Information:

Respondent skipped this question

 

January 2, 2019

3 comments

Thank you for your submission. The innovation team needs additional information to explore this proposed idea. Please elaborate on your responses as best as possible so that we may work through our review process.

•What would be the learning objectives for this project?
•How would these learning objectives be measured?
•How do you see this project being operated on a daily basis?

PubMed documents Toxocarosis in numerous studies, but mostly in countries less developed than the United States. One study from Turkey documents toxocarosis misdiagnosed as schizophrenia (https://www.ncbi.nlm.nih.gov/pubmed/18452258). PubMed documents Strongyloides hyper infection in alcoholics that can lead to mortality (https://www.ncbi.nlm.nih.gov/pubmed/22647849). Other studies suggest that worm infections are associated with cognitive impairment in children (https://www.ncbi.nlm.nih.gov/pubmed/9100486 https://www.ncbi.nlm.nih.gov/pubmed/8709928 https://www.ncbi.nlm.nih.gov/pubmed/2303010 https://www.ncbi.nlm.nih.gov/pubmed/4035735 https://www.ncbi.nlm.nih.gov/pubmed/6725991 https://www.ncbi.nlm.nih.gov/pubmed/7212174 https://www.ncbi.nlm.nih.gov/pubmed/1496701 https://www.ncbi.nlm.nih.gov/pubmed/1875063 https://www.ncbi.nlm.nih.gov/pubmed/6912220 )

PubMed literature search suggests a prevalence of parasites in mental health populations ranges from 4-18% (https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-015-1634-6 https://www.ncbi.nlm.nih.gov/pubmed/23626838 https://www.ncbi.nlm.nih.gov/pubmed/15250462 https://www.ncbi.nlm.nih.gov/pubmed/2132443 https://www.ncbi.nlm.nih.gov/pubmed/25101756 https://www.ncbi.nlm.nih.gov/pubmed/12055800 https://www.ncbi.nlm.nih.gov/pubmed/1558266 )

For Orange County this suggests 8,000 to 36,000 estimated cases of Toxocarosis in the mentally ill population.

The curious administrator at the Orange County Health Department may ask “Is this happening in Orange County to the extent that it is in less developed regions of the world?” The homeless/mentally ill population most definitely lives in conditions with reduced access to sanitation, clean water, food and shelter like those in less developed regions of the world. The next step in the scientific process is to collect data.

The main learning objective would be:
1) The prevalence of parasites in dogs and cats owned by people experiencing homelessness/mental illness. This is measured by dividing the number of unique positive animal case subjects by the sample size of the population.
2) The prevalence of dog/cat vector parasites in animal owners. This is measured by dividing the number of unique positive human case subjects by the sample size of the population
3) Reinfection rates of both animals and animal owners. This is measured by counting the number of cases that get reinfection and dividing by the total number of cases investigated.

To achieve this learning objective would require hiring veterinarians to screen animals for parasites and treat animals for parasites. Medical doctors would also be involved to test
blood/stool for animal owner infection and possibly treat infections found. Based upon the literature search conducted above, this service should be open to people experiencing mental illness, people experiencing alcoholism, people who live in poverty with children or children with mental retardation. The County of Orange can determine how best to reach the population of interest that it desires to study.

Thank you for your idea submission. Upon review and discussion, it was determined that this idea can continue moving forward at this time for further consideration and development. The Innovation team is currently exploring options for a community planning and engagement meeting where potentially viable ideas can be further discussed with local community members. Status updates will be posted as they become available.

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