Community Planning for Mental Health Services
To help ensure a healthy, productive community, individuals must be educated on, and have timely access to, both medical and behavioral health care services. The impact of not receiving needed behavioral health services is costly for the impacted individual and his/her family as well as the larger community.
Consider the following statistics reported by the National Alliance on Mental Illness (NAMI) at www.nami.org/factsheet:
- One in four adults experiences mental illness in a given year, and one in 17 live with a serious mental illness such as schizophrenia, major depression and bipolar disorder.
- Adults living with a serious mental illness die on average 25 years earlier than other Americans, largely due to treatable medical conditions.
- Approximately 20 percent of state prisoners and 21 percent of local jail prisoners have "a recent history" of a mental health condition.
- Serious mental illness costs America $193.2 billion in lost earnings per year.
- Mood disorders such as depression are the third most common cause of hospitalization in the U.S. for both youth and adults ages 18 to 44.
To help ensure that Central Texans have timely access to behavioral health care that addresses different levels of needs, the community has formed a number of stakeholder groups to collaborate on identifying these needs and planning evidence-based interventions to increase access to care. This article describes some of these stakeholder groups and some of the results of their planning efforts.
Psychiatric Services Stakeholders Committee (PSS). This group has been meeting since 2005 to address a critical community need for additional access to psychiatric crisis services. The stakeholder partners include leadership from the City of Austin, Travis County, Central Health, Austin Travis County Integral Care (ATCIC) -- the local mental health authority, private hospitals and community foundations and providers. While focused primarily on crisis services, the PSS also works to guide the development and implementation of an integrated behavioral health care system to include a full continuum of mental health and substance use disorder services. The committee focuses on high level policy and funding initiatives and decision making.
The Crisis Services Implementation Committee (CIC) advances the work of the PSS by focusing on system coordination and communication improvements. In addition, the CIC makes recommendations to the PSS on specific issues that need policy or funding decisions. Ad-hoc workgroups are created, as necessary, to address specific issues and report back to the PSS with recommendations and/or findings. The members of this committee include key leaders who bring a strategic understanding of the community behavioral health system to the planning process.
Behavioral Health Advisory Committee ( BHAC). The BHAC is led by Judge Nancy Hohengarten and convenes key members of the behavioral health, criminal justice and housing communities to coordinate planning efforts to support individuals with behavioral health care needs and promote public safety.
Substance Use Planning Group. This group is convened by ATCIC to create a community strategic plan focused on substance use services. The group will make recommendations to the PSS in 2015 on specific priorities and strategies.
All the workgroups in our community coordinate and communicate in order to ensure their efforts are aligned and that stakeholders are informed.
Behavioral Health Strategic Plan 2015-2019
Results of Prior Planning Efforts. The impact of the dedicated stakeholder groups working in the area of behavioral health is significant.
- A model of an ideal continuum of behavioral health care services for Travis County was collaboratively developed and is used to help identify gaps in care and propose new programs as funding is identified. The model identifies service needs from the least intense at the bottom of the pyramid to the most intense at the top.
- The consistent commitment of these groups has resulted in the expansion of existent but underfunded services as well as the creation of new behavioral health services for Central Texans.
- The past planning work laid the groundwork for over half of the county's 1115 DSRIP Waiver projects to be primarily focused on behavioral health services and provide new opportunities for care at all levels of the care continuum pyramid.
- New commitments from the St. David's Foundation, ATCIC, and Central Health will add services through a mental health crisis center, which will offer crisis stabilization for 24-48 hours.
Looking Forward. To ensure that service expansion and transformation is coordinated and efficiently and effectively planned, the community recently completed a community Behavioral Health Strategic Plan to guide efforts for the next five years. The plan benefitted from input from a number of organizations and consumers. Specifically, the plan focuses on the following areas:
- Monitoring the impact and sustainability of new community investments and the 1115 Medicaid waiver projects;
- Ensuring coordination of services which collectively function as a system of care; and
- Identifying and addressing additional gaps in the behavioral health system.
The stakeholders continue to honor the community commitment to a system of care that balances crisis and outpatient services.
Our vision is that Central Texas has a fully-integrated health system with no "wrong door" for access.
To this end, the following goals have been established:
Develop a health system that will:
Provide strong linkage and transitions between different levels of care for behavioral health in the health care system
Expand patient access to the right behavioral health care in the right place at the right time
Integrate behavioral and physical health into community based health services that promote prevention, recovery and wellness
Continue to collaborate on system improvements, monitor and evaluate impact and report findings in the behavioral health system
The full behavioral health strategic plan is in the process of being finalized. Once complete, it will be made available to all community partners. Individual organizations, stakeholder groups and other care providers can use the plan to align and prioritize efforts in order to continue to transform individually funded services into an integrated delivery system that creates a model healthy community.