Like many communities, a Midwestern city was faced with constrained resources when dealing with behavioral health patients; emergency departments and the county jail were often left handling most of these individuals. These facilities often felt like the default landing spot for this patient population and acted as a “revolving door,” especially for high utilizers. Wanting a more proactive approach to behavioral health, a coalition group led by a regional healthcare system and various key stakeholders from the county engaged the Catalyst team to determine the community’s behavioral health needs and the optimal strategy for implementing the plans over the short, intermediate, and long term.
Catalyst implemented a two-phase approach to evaluating behavioral health needs within the community. During Phase 1 we looked at current and future community needs and interviewed stakeholders to define gaps in care. Interviews were conducted with a variety of coalition members including a regional healthcare system, community health centers, a substance abuse center, the sheriff’s office, a school district, and organizations that serve the homeless population. Catalyst also looked at case studies for how communities around the country tackled behavioral health treatment.
Following the data-collection stage, we presented our baseline findings and held an on-site “visioning session” with representatives from involved organizations to walk through various behavioral health profiles created by Catalyst to better understand how each individual would seek help and receive treatment within the community. This group session helped shape the overall strategic direction for behavioral health in the area.
Based on our analysis of secondary data, case studies, and the work session with stakeholders it became clear that the community needs a more sustainable model of care for behavioral health. Over the long term, services – from job placement to primary care to treatment – should be integrated and co-located to ensure easy access.
However, because of capital constraints, Catalyst developed an à la carte plan that the team could roll out over several years. In the near term, we suggested right-sizing existing facilities and incorporating behavioral health services within the existing primary and urgent care infrastructure. Operationally, we recommended largely focusing on evaluating current assets, reorganizing the team into task force groups, developing a business and marketing plan, and increasing training efforts for select community groups. The intermediate tier suggested new facility investments in wellness and primary care as well as providing housing for violent patients; on the operational side we recommended building out medical detox and eating disorder service offerings, incorporating prevention and early interventions as demonstrated in various national case studies, creating more robust transportation, and initiating an operational study to assess processes and hours. Longer-term, we ultimately suggested moving toward a community and comprehensive facility model of co-located resources.