Integrate services, diversify programs and collaborate with others in your community to improve care for people suffering from mental health illness or substance abuse, hospital leaders said yesterday at an AHA Annual Membership Meeting briefing on behavioral health care.
Taking place during National Mental Health Awareness Month, the briefing examined innovative approaches to addressing behavioral health issues. Hospital leaders described how they are tackling the problem by fostering community partnerships, integrating services across care settings and setting up regional dedicated psychiatric emergency services, or PES.
A PES is a stand-alone emergency department (ED) unit designed specifically for psychiatric facilities. At PES facilities, patients are evaluated, receive intensive treatment and given time for observation and healing.
“The goal of PES programs is to stabilize acute symptoms and avoid psychiatric hospitalization when possible,” said Scott Zeller, M.D., John George Hospital’s chief of psychiatric emergency services in Oakland, Calif. He spoke about the “Alameda model” of emergency psychiatric care adopted in California’s Alameda County – home to about 1.5 million people.
It provides “round-the-clock” mental health services that can be accessed either by ambulance or direct transfers from any county ED. Patients also can self-present for care. When patients arrive at the PES, they receive treatment from psychiatrists, nurses and other affiliated personnel for up to 24 hours onsite.
“PES perfectly aligns with the goals of health care reform in improving access to care and quality of care and timeliness of care, while dramatically lowering avoidable costs,” Zeller asserted.
Renee Romberger, Spartanburg (S.C.) Regional Healthcare System’s vice president for community health policy and strategy, explained how her organization partnered with others in the community as part of a broader community health improvement strategy. The hospital’s leaders talked one-on-one with others in the community, because “if you are going to develop a comprehensive strategy it has to come from the top,” Romberger said. Those conversations led to creation of a 21-member community behavioral health task force charged with identifying the resources needed to provide the most appropriate and effective mental health services.
The task force developed strategies like SBIRT (screening, brief intervention, referral and treatment) – a widely recognized model to identify and address basic behavioral health and substance abuse issues. A comprehensive training program is available to all area medical students, nurses, guidance counselors, EMS personnel, public safety officers and clergy – those who Romberger said are in the best position to identify and assist those in need.
“You need to be the spark that ignites people in the community and then get out of the way,” she said.
ProMedica Health in Toledo, Ohio, has teamed up with Harbor Behavioral Healthcare in an effort to bring more mental health clinics and other mental health services to Toledo and surrounding communities. ProMedica Health President and CEO Randy Oostra said the affiliation has led to standard care protocols, guidelines and best practices around managing behavioral health disorders, and a sharper focus on wellness, prevention and education aimed at reducing the stigma of a behavioral health diagnosis.
“It’s about hospitals and systems owning the integrated care model,” he said. He added that hospitals need to improve the behavioral discharge planning and response process to ensure that people in need receive help immediately and don’t get lost in the system. “We need to integrate more services within our primary care practices,” he said. “And in addition to making more services available, we need to train more physicians, and utilize technology that will allow us to provide care to larger populations.”
The briefing was moderated by AHA board member Tom Huebner, president and CEO of Rutland (Vt.) Regional Medical Center. His hospital in 2013 opened a dedicated opiate treatment facility in downtown Rutland that treats 400 patients a day.
“We’re no longer responsible just for fixing people once they’ve been broken,” he recently told AHA News. “We have a responsibility for sustaining and improving the health of our community.”