Almost every family is impacted by trauma or mental illness. One in four people in the world will be affected by mental disorders at some point in their lives, and around 450 million people currently suffer from mental health conditions. Despite how widespread mental illness is, mental health treatment and care is often underrepresented at a community-level. Community mental health centers can not only help combat the stigma around mental illness, but also help improve patient outcomes for those who need care most. In this post, Randy Callstrom, the President and CEO of Wyandot, Inc., discusses how community mental health centers can help de-stigmatize mental illness.
Community mental health centers and value-based care
Cerner: What is a community mental health center (CMHC), and what patient population does it serve?
Randy Callstrom: President John F. Kennedy signed the Community Mental Health Center act in 1963, and created CMHCs across the country. Wyandot Inc. covers Wyandotte county. A CMHC is a safety net clinic, which means that we provide services regardless of someone’s ability to pay, which is contrary to providers who might only take private insurance or out-of-pocket payments. We provide care to people ages three to 93, and we treat everything from grief and loss, to trauma from physical or sexual abuse, depression or anxiety, to very severe mental disorders such as schizophrenia. We provide traditional outpatient counseling, psychiatric services, and we have specialized services working in homes, schools, and business to help people who do have severe mental illness be successful.
For Wyandot – and any community mental health center, really – the overarching goal is to help people be able to live successfully in their own community.
How is the shift to value-based care affecting the community mental health center model?
I think in general, and especially at Wyandot, which is located in Kansas, we're still very much living in a fee-for-service world – that is, we provide an hour of service and get paid for that hour. However, we're piloting some projects on a pay-for-performance or value-based system – those are just in the beginning stages right now.
Ultimately, value-based care will be about looking more holistically at our clients and getting paid for outcomes rather than by the hour. For example, it means getting our diabetes clients to get their annual check-ups, even if they aren’t coming to us for help with diabetes.
How community mental health centers engage with the community
Often, community mental health centers provide more services than traditional counseling and psychiatry. Walk us through some of the different offerings at Wyandot Center for Community Behavioral Healthcare.
Case managers work with children or adults who need intensive support and services to be successful. They work directly with the client where they live, go to school, and work, and they coordinate care with other professionals, family members, and other supportive individuals who care about them.
We also have homeless outreach services, where we connect homeless people living with mental illness to mental health services and help them find housing and work. In our adult services, we have a vocational program that helps people with severe mental illness who want to work find employment, so we're working both with the individual client to prepare for a job and recruiting and educating prospective employers. We also have partnerships with the local school districts, including the Wyandot Academy, which is a specialized program for children with special education needs who are also experiencing severe emotional and behavioral disorders.
Finally, we have a 24/7 crisis stabilization center called RSI, which provides persons experience a mental health or substance abuse crisis with an alternative to the hospital, emergency rooms or jail. We have a very strong partnership with Wyandot County law enforcement and the court system, and we have been instrumental in partnering with the mental health court. We also have co-responders that are dispatched with law enforcement when someone is in a mental health crisis.
We have trained 80 percent of local law enforcement officers on mental health crisis intervention (CIT). And, while there nearly 40 percent of people in the jail today are experiencing mental health issues, we have made such great strides as a community in ensuring people get care or treatment they need. Recently, for example, there was a young man who was engaged in our services and came to the attention of law enforcement for something that was not a violent crime, but which could have landed him in jail. He worked with the court system and with us, and rather than going to jail, this person accessed the care and treatment that he needed. It's kind of that adage of getting the right care and treatment at the right time and the right place.
Fighting the mental health stigma
There’s a lot of stigma surrounding mental health disorders. How does a community mental health center help to fight the stigma?
It’s important to recognize that a community mental health center can’t fight stigma alone. A community can do it in many ways – and one is just making it OK to talk about it. Employers can help by making sure mental health resources are available to their staff, and assuring that people are supported, rather penalized, regarding their mental health needs.
The other thing that can help in de-stigmatizing mental health is in calling on people who are well-known in the community – sometimes that’s an athlete, a politician or a celebrity – and asking them to talk about mental health. De-stigmatization starts at various levels, and level one is grassroots – it’s really about getting the community at large to know that it's OK to talk about it.
I believe strongly in the Mental Health First Aid program, a national program that workplaces can adopt and which provides education on how to recognize mental illness and substance abuse. The more people we can get to receive Mental Health First Aid training, they will realize how common mental illness is.
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Attend the Mental Health Kansas City 2018 conference on May 4 at Cerner’s Innovations campus in Kansas City. Sign up and get more details here.