Wednesday, November 19, 2008

An Innovative Solution for Those with Mental Illness (Part I)

As we discussed in my last blog post, Catholic Health World, a publication of the Catholic Health Association of the United States, recently published an article on CHRISTUS’ practice of using Community Health Workers (CHWs) to help patients access behavioral health services in Texas.

We originally used CHWs to help patients get through the health care system as expeditiously possible and provide them with resources that permit them to monitor their health care status at home, hoping that they will require less costly health care services in the future.

In the city of Corpus Christi, Texas and other rural communities in the area where CHRISTUS facilities are located, CHWs are participating in a pilot program to help patients with mental illness. It is clear that limited resources are allocated to mental health, especially in remote rural communities.

These CHWs are tasked with making sure that seriously mentally ill patients get their medical and dental needs met and that medical patients get screened and treated for situational depression, debilitating anxiety and substance abuse. To be considered for care by a CHW specializing in helping clients with mental illness, a patient must have had two psychiatric hospitalizations in as many months or had three psychiatric admissions within 12 months. Patients are also usually uninsured and can’t be currently enrolled as clients of the state’s Community Mental Health and Mental Retardation system, which provides medical services exclusively to people with bipolar disorder, schizophrenia and major depression. Patients generally stay in the program for three months.

They are offered the Aggressive Community Treatment program (ACT), which is reserved for patients who have no resources, poor life skills and nowhere else to turn. ACT is free to patients. In this way, it addresses not only poor mental health, but many of the contributing factors that exacerbate it.

Some of these CHWs meet candidates for the program while they are patiens in the behavioral health unit at CHRISTUS Spohn Hospital Corpus Christi – Memorial. They then offer to help the patient with some of the factors that fueled the chain of events that led them to a hospitalization. Eventually, the CHW will hand these patients totally to the care of the state’s mental health system, but in the first 90 days after psychiatric hospitalization—a critical time—the CHW works to stabilize a patient on medication as directed and aid in securing everything from sobriety programs, housing aid and job hunting assistance. Many times, the CHW will check in on new patients daily.

We have seen this pilot program bring impressive results in South Texas. One of the best measures of success in the treatment of serious mental illness is the measure of time that patients can successfully function in the community. Only six of approximately 40 individuals in the program in the first year were readmitted to the hospital.

It is important as CHRISTUS continues to care for our patients in these increasingly tough financial times that we remain committed to our mission and ensuring that we have the resources to sustain this care for years to come. One of the ways we do this is by creating new programs that care for our communities in cost-effective ways.

It is my belief that in a system the size of CHRISTUS Health, someone, somewhere has devised a best practice for almost every action we undertake in our facilities. That is why we are so committed to our Touchstone Awards—which annually recognize best practices throughout our system. This Community Health Worker program is just one of the examples of innovation at work in CHRISTUS Health, and I am hopeful that we will continue to collect data and share this as a proven best practice in the future.

No comments: