Project Grant H79FG000818

IMPLEMENTATION OF SERVICES AND MENTAL HEALTH CARE CONNECTION IN THE MENTAL HEALTH COMPONENT OF OUR HOSPITAL-BASED VIOLENCE INTERVENTION PROGRAM (HVIP), AT-RISK INTERVENTION AND MENTORING - PROJECT NAME: IMPLEMENTATION OF MENTAL HEALTH SERVICES IN OUR HOSPITAL-BASED VIOLENCE INTERVENTION PROGRAM SCOPE: THIS PROJECT CONTINUES OUR HOSPITAL-BASED VIOLENCE INTERVENTION PROGRAM (HVIP), CALLED THE AT-RISK INTERVENTION AND MENTORING PROGRAM (AIM), BUT FOCUSES ON THE GAP OF ASSESSING FOR MENTAL HEALTH ISSUES, AND PROVIDING MENTAL HEALTH SERVICES IN A RESPONSIBLE, CULTURALLY APPROPRIATE WAY TO REDUCE VIOLENCE RECIDIVISM AND ASSIST PATIENTS IN EXITING A CYCLE OF VIOLENCE. POPULATION: WE PRIMARILY SERVE THE 6TH CONGRESSIONAL DISTRICT OF COLORADO. AS A LEVEL 1 TRAUMA CENTER WE SERVE ALL PATIENTS AGED 14 AND OLDER WHO PRESENT TO OUR HOSPITAL. OUR POPULATION OF FOCUS IS VIOLENTLY INJURED PATIENTS, AND THESE PATIENTS ARE 85% MALE, 90% BEING NON-WHITE. INTERVENTION: OUTREACH WORKERS ARE HIRED THROUGH THE GANG RESISTANCE AND SUPPORT PROGRAM (GRASP) AND ARE CONTRACTED EMPLOYEES AT THE UNIVERSITY OF COLORADO HOSPITAL. WHILE THEY WORK FOR GRASP, THEIR PRIMARY RESPONSIBILITY IS TO THE HOSPITAL-BASED PROGRAM. THIS PROPOSAL REQUESTS FOUR OUTREACH WORKER DUE TO THE ENGAGEMENT RATE WE HAVE HAD. THE OUTREACH WORKERS CAPITALIZE ON THE TEACHABLE MOMENT BY RESPONDING TO BEDSIDE WHEN A PATIENT IS ADMITTED WITH AN INTENTIONAL TRAUMATIC INJURY (GUNSHOT WOUND, STABBING, ASSAULT). AT THIS MOMENT, PATIENTS NEED TRAUMA-INFORMED ADVOCATES TO HELP THEM NAVIGATE THEIR HOSPITAL STAY AND ARE MORE OPEN TO SEEKING HELP IN AVOIDING RISKY LIFE CHOICES AND CHANGING THE TRAJECTORY OF THEIR FUTURE. DURING A BEDSIDE VISIT, OUTREACH WORKERS CONNECT WITH THE PATIENT AND HELP THEM PROCESS THEIR TRAUMATIC EVENT. OUTREACH WORKERS IDENTIFY ANY CONCERN FOR RETALIATORY VIOLENCE AND WORK TO DE-ESCALATE THE PATIENT WHILE ALSO PROVIDING SUPPORT. THE OUTREACH WORKERS PARTNER WITH THE HOSPITAL SOCIAL WORKER AND CASE MANAGER TO HELP GUIDE PATIENTS THROUGH MENTAL HEALTH CARE AND RISK REDUCTION RESOURCES OFFERED THROUGH THE HOSPITAL, CITY AND COMMUNITY, AND MAY FOLLOW THE PATIENT FOR UP TO 18 MONTHS. GOAL 1. ASSESS THE IMPLEMENTATION OF MENTAL HEALTH ASSESSMENT AND SERVICES IN OUR HVIP - OBJECTIVE 1: IDENTIFY BARRIERS AND FACILITATORS TO IMPLEMENTATION OF ASSESSMENT MEASURE (START TOOL) THOUGH INTERVIEWS WITH OUTREACH WORKERS AND SOCIAL WORKER. (QUALITATIVE) - OBJECTIVE 2: EVALUATE RATE OF MENTAL HEALTH DIAGNOSIS AND SERVICE CONNECTION IN THE COMMUNITY FOLLOWING DISCHARGE, INCLUDING RATE OF APPOINTMENT ATTENDANCE WITH THE THERAPISTS OF COLOR COLLABORATIVE. (QUANTITATIVE) - OBJECTIVE 3: INCREASED HEALTH SERVICES CONNECTION AND UPTAKE OF INSURANCE COVERAGE FOR HOSPITAL GOAL 2. ASSESS THE EFFECTS OF MENTAL HEALTH NAVIGATION/SERVICE CONNECTION ON MULTIPLE OUTCOMES. - OBJECTIVE 1: INTERIM REPORTS WITH EFFECTIVENESS AND COST-UTILITY ANALYSIS AT EACH FISCAL YEAR INTERVAL - OBJECTIVE 2: DECREASED VIOLENT INJURY RECIDIVISM TO THE HOSPITAL - OBJECTIVE 3: SUCCESSFUL TREATMENT OF MENTAL HEALTH CONDITIONS SUCH AS PTSD, DEPRESSION, SUICIDALITY - OBJECTIVE 4: DECREASED RECIDIVISM FOR MENTAL HEALTH ISSUES IN THE EMERGENCY ROOM WE ANTICIPATE ENROLLING AT LEAST 125 CLIENTS THIS YEAR, WITH INCREASE UP TO 200/YR OVER THE LIFE OF THE PROJECT GIVEN CURRENT POPULATION GROWTH. THERE IS NO ANTICIPATED STOP DATE FOR OUR PROGRAM AS WE ANTICIPATE THAT IT WILL CONTINUE TO BE NEEDED FOR SEVERAL YEARS