Understanding the community mental health system
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UNDERSTANDING THE COMMUNITY MENTAL HEALTH SYSTEM Julie de Losada, Laura Davis Yen . July 27, 2011 CHILDREN, YOUTH, AND FAMILIES
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CHILDREN, YOUTH, and FAMILIES. Understanding the community mental health system . July 27, 2011. Julie de Losada, Laura Davis Yen . CMHA. CMHA. CMHA. Centers for Medicare & Medicaid Services . Federal Government. Mix of State Mental Health and Federal $$. DSHS. DDD. other. ADSA. - PowerPoint PPT Presentation
Transcript of Understanding the community mental health system
UNDERSTANDING THE COMMUNITY MENTAL HEALTH SYSTEM
Julie de Losada, Laura Davis Yen.
July 27, 2011
CHILDREN, YOUTH, AND FAMILIES
Federal Government
DSHS
DBHR
ESH WSH
RSN
CMHA CMHA CMHA
CLIP
ADSA DDDCA JRA otherother
Centers for Medicare & Medicaid Services
Mix of State Mental Health and Federal $$
• Pearl Street• McGraw• CSTC• Tamarack
• Catholic Community Services NW• Whatcom, Skagit, Snohomish
• Compass Health• Skagit, Snohomish, San Juan
• SeaMar Behavioral Health• Skagit, Snohomish, Whatcom
• Whatcom Counseling & Psychiatric Clinic
North Sound Mental Health Administration
• Region 2 North
• NSMHA
From Washington to Washington…
39 Counties Grouped into 13 RSNs
How NSMHA works with Volunteers of America
It All Starts at “ACCESS”
Access to Care
4 Ways to Enter the Community Mental Health System
1. Crisis Services2. Outpatient Services3. Inpatient Services*4. CLIP*
*Neither NSMHA nor our Providers deliver inpatient or CLIP services. NSMHA may authorize for these levels of care.
Volunteers of America (VOA)
Role of VOA
24/7 Phone Crisis Intervention (800-584-3578)
24/7 Triage Clinician Line (800-747-8654)
Regional Lifeline call center (1-800-273-8255)
ACCESS to Outpatient counseling (888-693-7200)
Inpatient Certification & Authorization (800-707-4656)
Offers ASIST and SafeTALK community trainings
Accessing Crisis Services
24/7 Phone Crisis Intervention Services100,000 Annual Total CallsServing Five North Sound CountiesSelf-Defined CrisisMental Health Professional Staff
Accessing Outpatient Services
MUST meet Medicaid Financial Eligibilityo Established by Community Service Office (CSO)
MUST have a covered “Access to Care” diagnosis
MUST meet “medical necessity”
MUST call ACCESS to Mental Health Services
Access to Care Standards
Examples
Access to Care Standards Continued
RSN/ CMHA Service
Outpatient services offered by NSMHA contracted Community Mental Health Agencies Catholic Community Services NW Compass Health SeaMar Whatcom Counseling and Psychiatric Services
ALL Providers Offer…
Assessment/ Evaluation Individual Therapy Group Therapy Family Therapy Medication Management Case Management Coordination with formal systems Coordination with natural supports
SOME Providers Offer… CHAP – Children’s Hospitalization Alternative Program
Co-Funded by Children’s Administration for 16 yrs. Individualized/ intensive care In-home & out-of-home Respite 24/7 Crisis Response
Wraparound Family-driven/ Youth-Guided Team Based Natural Supports Community Based Culturally Competent Strengths Based Collaboration Persistent Outcomes Based
INTENSIVE SESSION Systems of Care and
Wraparound: An Overview
DAN EMBREE
2:40 RM 565 B/C
Assessments and Evaluations
How Long Does it Take to Get an
Appointment??!?!?!
Time Lines
14 Calendar Days from Request to Intake
28 Calendar Days from Intake to First Ongoing
7 Calendar Days from Inpatient Discharge to
Intake or First Ongoing.
Each person has a unique combination
of strengths and needs.
Services should be designed to:
Utilize Strength
s
Meet Needs
In the least restrictive / most
normative manner
Individual and Tailored Care
Family Voice and Participation
ASSESSMENTS BASED ON FAMILY STRENGTHS
AND NEEDS
• Needs are not Services
FAMILIES SHOULD BE INCLUDED IN THE ENTIRE
PLANNING AND TREATMENT PROCESS
• It’s not about us with out us.
Considerations for Adolescents
Youth who are thirteen and older can request mental health services without the consent of their parents. RCW 71.34.500
Youth who are thirteen or older and who are a danger to themselves or others, and refuse treatment may be involuntarily detained and hospitalized. RCW 71.34.710
Planning Ahead…
Transitioning to the Adult Mental Health System
Preparing for the transition Discuss transitioning to an adult mental health provider with the current mental
health provider: Timing of the transition Which agency and program can best meet the young adult’s needs? Keep in mind, some programs take time to get into
Apply for Medicaid if appropriate: Medical Cash assistance Food Benefit
Research and plan for housing: Housing authorities’ programs including voucher programs and public housing Some mental health agencies have limited housing resources
Preparing for the transition, Continued
Community Resources: research what other assistance is available in your community Food Banks Transportation Options Discounted utilities
Any special needs
Develop skills for independent living
Plan for employment/education/daily activity
Teach/coach the youth how to communicate about and navigate health care; they will be driving their own care as an adult.
The Adult Mental Health System at a Glance
A Brief Overview…
Inpatient MH Treatment
Accessing Inpatient Services
2- Ways •Voluntary•Involuntary
RCW 71.34.600
•(1) A parent may bring, or authorize the bringing of, his or her minor child to an evaluation and treatment facility or an inpatient facility licensed under chapter 70.41, 71.12, or 72.23 RCW and request that the professional person examine the minor to determine whether the minor has a mental disorder and is in need of inpatient treatment.
When is Inpatient Appropriate?
Needs crisis stabilization in order to avoid a higher level of care.
Potential danger to self, others, or property.
Caregiver or youth are unable to ensure safety.
Needs constant supervision and adult intervention to assure safe environment
Inability to think clearly or distinguish reality.
AND other less restrictive services have been tried which were not successful or were unable to ensure the youth's safety
When is Inpatient Inappropriate?
When less restrictive interventions have not been attempted.
Solely for “medication adjustments” or “medication vacations”.
In lieu of “placement”.
When another system can better or more appropriately serve the child/youth (detention,
Children’s Administration, primary care etc.)
When the crisis and youth’s primary diagnosis are not directly related to mental health diagnosis.
What to expect…
Time limited crisis stabilization (5-10 days) Limited psychiatric evaluation/assessment Possible medication assessments/ adjustments Coordination with outpatient provider (if there is one) Coordination with other systems (if indicated) Discharge Planning
More about Inpatient Services
NO child/youth psychiatric inpatient facilities in our region.
ALL child/youth psychiatric inpatient facilities in WA are private.
Fairfax (6-17)
Seattle Children’s
(6-17)
Two-Rivers Landing (11-17)
Kitsap Youth Inpatient
Unit (8-17)
Contacts
For more information, contact:
NSMHAwww.nsmha.org360.416.7013
Julie de Losada, M.S. [email protected]
Laura Davis Yen, LICSW [email protected]
Questions?
