PROMOTING INTEGRATION ACROSS THE SYSTEM OF CARE
Combining crisis stabilization services and supportive housing on a recovery campus
Douglas County health care agencies are collaborating to build an integrated system of care that moves from crisis and illness as a norm to recovery and prevention as a practice.
To achieve that vision, the Health Leadership Coalition (HLC) has developed a proposal to build a recovery campus located immediately adjacent to Bert Nash Community Mental Health Center and across the street from Lawrence Memorial Hospital and Heartland Community Health Center.
The proposed campus will have the following buildings and services for individuals with serious mental illness and substance use disorders:
- The 14-bed crisis center would be open 24/7 and provide: 23-hour observation, medication-assisted detox, crisis stabilization for up to 72 hours, respite beds for stays of up to 14 days.
- This housing, which will be a congregate-style living setting, will serve up to 12 clients of Bert Nash Community Mental Health Center. These clients will attend programs designed to enhance their recovery and transition back into the community. Length of stay generally will be 6 to 12 months, but may vary depending on the client's stage of recovery.
Permanent supportive housing
- There will be 10 permanent supportive housing apartments owned and operated by the Lawrence Douglas County Housing Authority. Residents will be individuals with a diagnosed behavioral health condition and required to meet established criteria determined by the Housing Authority to live in the apartments. Individuals can stay in them forever, if needed, or they can transition out of them.
Deploying an integrated crisis team in the Lawrence Memorial Hospital Emergency Department
The core idea of an Integrated Crisis Team (ICT), embedded in the ED, is to embrace the integrated behavioral health/primary care model that meets patients where they are and provides immediate behavioral health intervention, consultation, and treatment to ensure better outcomes. The ICT innovation extends that model to the ED environment, alleviating many of the difficulties patients encounter as a result of the constant, urgent demands placed upon the ED physicians’ time and attention
The ICT model also builds upon a subset of Assertive Community Treatment (ACT) practices by providing a dedicated, interdisciplinary, multi-agency care team to provide short-term care coordination and bridge case management following discharge from the Emergency Department. This care coordination, provided by Heartland RADAC, is available for up to ninety days following discharge from the ED.
Creating a Douglas County Peer Fellow Program
The Douglas County Peer Fellows program will build peer support capacity in our community, develop our peer workforce and shape a culture of recovery wherever Douglas County residents live, learn, work and play. The program will connect trained individuals, sharing insight and wisdom gained through lived experience, to community members who struggle with mental illness and addiction. These peer specialists will provide emotional and social supports along with resources that can lead to better health outcomes.
Expanding mobile response and implementing an integrated 24/7 crisis line
Mobile Response services are short-term, face to face services designed to restore a person’s mental health functioning level to pre-crisis levels. Crisis assessment, intervention, and stabilization services are provided on-site where the individual is located. Mobile mental health crisis response services offer opportunities to de-escalate a situation or problem and to help people develop individualized strategies to ensure safe resolutions and interventions are put into place.
Expanding the WRAP program
WRAP (Working to Recognize Alternative Possibilities) is a school-based mental health program through the Bert Nash Community Mental Health Center that provides mental health professionals to local schools. The goal of the program is to help students succeed in school by addressing their social and emotional health needs. WRAP has been in existence since 1997 and was developed by Bert Nash in partnership with Lawrence Public Schools. WRAP was initially supported through funding from the Federal Department of Juvenile Justice and Delinquency Prevention.
The WRAP program provides services and interventions such as:
- brief psychotherapeutic interventions
- individual or group counseling
- skill building in response to discipline referral
- support service brokerage and linkage for children, youth and families
- crisis intervention
- liaison between schools and health care agencies
Currently, WRAP is available in the following schools: Lawrence Public high schools, middle schools and six elementary schools, Douglas County Juvenile Detention Center, Eudora Elementary School and Bishop Seabury Academy. In 2018, WRAP, which cost $1.1 million, was funded by:
- Douglas County Government
- Lawrence Public Schools
- Bishop Seabury Academy
- Eudora Public Schools
- City of Lawrence
- Bert Nash Endowment
Funding from Proposition 1 — the quarter-cent sales tax that was approved in November for behavioral health services and facilities —will provide an additional $260,000 in county funds to support the expansion of WRAP in Eudora and then to provide services in Baldwin City and Lecompton, beginning in the 2019-2020 school year.