This CEO Used His Passion for Behavioral Health to Engage His Providers and Community in an Innovative Model of Care

by HCE Exchange on January 6, 2016

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Mental and behavioral health services have often been overlooked or disjointed within the country’s healthcare system. Mental health touches almost every aspect of a person’s life, making collaboration among medical service providers and community resources essential to properly caring for these individuals.

Treating the neediest with compassion and dignity

Most chronically homeless people suffer from severe mental health issues, making it difficult for them to break out of the cycle of homelessness, and many self-medicate with alcohol or drugs. One center in Texas has made huge strides in caring for some of the most challenging cases through empathetic care and community partnerships.

The Center for Health Care Services in San Antonio, Texas, has instituted a number of programs from police crisis intervention training to a physician roundtable to provide holistic care for individuals with mental health and substance abuse problems. The center’s innovative program began in 2002 and operates under the leadership of Leon Evans, CEO, who has nearly 40 years of experience in mental health.

“There are various degrees of mental illness, but the very ill tend to have multiple problems and often end up resistant to treatment and uninsured,” Evans said. “They have destroyed relationships with family and friends, so there’s no one to remind them to take medications or help them get treatment. We want to help those people.”

Evans leads the center’s programs with the patients in mind, treating even the most desperate cases with respect and dignity. The compassion and empathy he shows serves as the inspiration for the hugely successful programs the center employs, including the 24/7 Crisis Care Center, Crisis Intervention Training, The Restoration Center and the Bexar County Jail Diversion Program.

Evans’ passion for people originated early in life when his father suffered mentally, emotionally and physically after serving in World War II. He experienced the effects of mental illness on a family and the struggles inherent in getting proper treatment. His passion was further cemented during a volunteer child psychiatry program he participated in during college.

Providing options to officers and the prison system

In 2002, the Center began providing Crisis Intervention Training for police officers to help them de-escalate situations involving persons undergoing a mental health crisis. The traditional police training of “command presence” and “command voice” tends to further agitate individuals in this state and can lead to the person or the officer being harmed.

At first, the training wasn’t met with enthusiasm from officers.

“People in mental health and law enforcement are overworked and underfunded,” Evans said. “We don’t have the same goals or speak the same language, but we needed to come together.”

After the first day, however, the officers came to see the value of the training, and the county police chief and sheriff have mandated the training. As a complement to the training, the Center instituted a diversion program to provide officers a place besides jail or the emergency room to take someone having a behavioral health problem. The center created space near an urgent care center and found the funding to keep the center open 24/7 so that officers could obtain medical clearance and psychiatric evaluations for individuals picked up on the street.

Evans estimates about 25,000 people are diverted away from the county jail and the emergency rooms, which also saves taxpayers money by reducing magistrate costs.

The Center also took on helping nonviolent offenders in the overcrowded Texas prison system, many who have severe mental illness. Evans said the prison system developed a new division for inmates with mental illness, who were put on parole under the condition they see a psychiatrist, take medication and clear regular alcohol and drug screenings. He estimates that when these people receive treatment 6% or less commit a felony within their parole period, significantly fewer than the general population which ranges between 40 and 60% statewide. Offering treatment to those diverted from jail

When an officer diverts an individual from jail or the emergency room, the person starts in the observation unit or detox/sobering unit. Once sober, they are given the opportunity to receive treatment.

“We give them showers, feed them, and treating them with dignity and respect,” Evans said. “Individuals are then able to enter The Restoration Center.”

The Restoration Center is an integrated clinic where people can receive psychiatric care, substance abuse services, general healthcare services and transitional housing. It is run by people in recovery so those who choose to enter can see what’s on the other side.

Of people brought in by police, Evans estimates that about 20% choose to go through detox, an impressive percentage, considering most of these people would not have been reached for treatment otherwise.

The Center also provides two dorms as transitional housing for men and women, who can stay up to 120 days. The program began about 4 years ago, and more than 60% of people who complete the program are now living drug-free and working.

Partnerships and community connection key to success

Evans said working closely with law enforcement, hospitals, physicians and others in the community has been key to keeping the program successful. Although underfunded, the Center seeks out any available money through state and federal funding, grants, payers and any other sources and manages to keep the center adequately funded.

To prove success and further encourage funding, Evans keeps detailed data on all programs and conducts a physician roundtable monthly to review results and keep all parties engaged.

For others considering developing integrated mental health programs, Evans encourages them to evaluate all community resources and existing data to find a model that works.

“Everyone needs to come up with their own model,” he said. “We all have different resources. What’s made our model work is that all parties have been involved in developing solutions and take pride in the outcomes.”

by Patricia Chaney

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