A clear vision for mental health system improvements

Published December 20, 2014

Correction: This is a correction of an earlier post that included the wrong picture of Dave Richard. We apologize for the error.

 

by Dave Richard, Deputy Secretary, DHHS, published in Asheville Citizen-Times, December 19, 2014.

Improving North Carolina’s Mental Health System is a high priority for Gov. Pat McCrory and Health and Human Services Secretary Aldona Wos. Together, they share a clear vision and steadfast resolve to make significant improvements in a rapidly changing health care arena.

This vision is clear: Provide the needed treatment and service for people with mental illness in their communities based upon a recovery model, focus on prevention and community treatment to help reduce emergency department visits, provide assessment and intervention as close to home as possible when a crisis occurs, provide comprehensive follow-up service to avoid future crises, and eliminate the stigma associated with mental illness so people will seek treatment when needed.

North Carolina’s mental health system has had numerous changes over the past decades. These changes, while all well-intentioned, resulted in a fragmented service system that has not met the needs of our citizens. Most often the goal was correct but lacked the focus needed to achieve critical results.

Our vision includes an aggressive effort involving stakeholders from across the state to ensure that we stay on the path toward success. Secretary Wos’ Crisis Solutions Initiative provides the framework for our efforts. When announced in December 2013, she stated that we will look to our communities for solutions and will define clear measures to review our progress.

One year later, we have seen demonstrable progress. The Crisis Solutions Coalition is composed of diverse stakeholders including hospitals, health care providers, law enforcement, legislators, professionals in the mental health field and people with mental illness and their families. Over the past year, these meetings have identified key elements for the state to concentrate on, but more importantly, have allowed us to gather and share information on what is working across North Carolina.

In partnership with the General Assembly, additional funding was appropriated for items identified as priorities by the coalition and communities across North Carolina. We have a long way to go, but these meetings are showing key results that we need to bring North Carolina’s mental health system forward.

Our Local Management Entities/Managed Care Organizations (LME/MCO) are another key partner. These groups are adjusting services to focus on prevention and early treatment. In Asheville, for example, the current Smoky Mountain Center administrative office is converting to a comprehensive crisis center. This will bring a broad spectrum of community crisis services that will help reduce dependency on emergency departments as the first treatment option for individuals needing care.

Across North Carolina, our LME/MCO system is shifting funding to community-based treatment systems. This is evident through the urgent care centers for mental health, walk-in crisis services to avoid emergency department visits, more robust community treatment models that support people in recovery and increased capacity of inpatient psychiatric beds.

The Governor’s Medicaid Reform plan will link our behavioral health system to Accountable Care Organizations and is another key component to success for our mental health system. The vast majority of people who have a mental health issue are first seen by their primary care doctor. Improved collaboration and clear incentives for early treatment will make a significant impact on North Carolina’s mental health system.

Mental health issues have a wide-ranging impact on multiple systems in our state. We can begin to address the number of people who are in our criminal justice system because of mental health issues that could be reduced through early intervention and treatment. Additionally, training opportunities such as the Mental Health First Aid program can assist families and lay leaders in identifying people who may be experiencing early signs of mental illness and get them the assistance they need.

A system that focuses on effective early treatment ultimately will have a tremendous impact on our state by addressing needs before they become problems. We must continue to work with our communities to execute the vision we have laid out, knowing that steady progress may not create headlines, but will save lives.

Western North Carolina has had strong political leaders who championed improved mental health services from a bipartisan perspective. Our vision builds upon their legacy of caring and in time will achieve the goal of quality care for all who need it.

Dave Richard is Deputy Secretary of Behavioral Health and Developmental Disabilities Services, DHHS.

http://www.citizen-times.com/story/opinion/contributors/2014/12/19/clear-vision-mental-health-system-improvements/20650503/