Family & children's services (FCS) bridging the GAP project - family & children's services (FCS) in tulsa, oklahoma proposes "bridging the GAP" a multi-tiered project to improve transitions of care…

Family & children's services (FCS) bridging the GAP project - family & children's services (FCS) in tulsa, oklahoma proposes "bridging the GAP" a multi-tiered project to improve transitions of care from inpatient or crisis to outpatient care for adults and children. Addressing covid's impact on mental health, this project will implement strategies to overcome transition barriers to outpatient care by augmenting inpatient discharge and follow up teams while enriching client engagement to improve clinical outcomes and prevent rehospitalization. FCS, the largest community mental health center (cmhc) in oklahoma, will expand services for vulnerable child and adult populations (SED/SMI/COD) impacted by covid-19, with an emphasis on minorities and individuals (uninsured, underinsured, african americans, hispanics and american indians) residing in economically disadvantaged communities in tulsa county. The project will serve 500 individuals per grant year: 250 (annually) adults living with SMI/COD who are discharged from psychiatric hospitalization and in need of enhanced transition support to outpatient behavioral health care services and 250 (annually) children living with SED who are discharged from psychiatric hospitalization in need of enhanced transition support to outpatient care or are students in the tulsa public school (TPS) system in need of school-based intervention and/or outpatient behavioral health care services. The goals of the proposed project are to increase the number of adults living with SMI/COD, and children living with SED, who actively participate in post-hospitalization outpatient treatment by using proven strategies to effectively bridge clients to outpatient care in order to improve clinical outcomes; develop a mobile crisis response and stabilization intervention for tulsa public schools district (77 schools) for children presenting in crisis during the school day; and improve the school system's ability to respond to children with mental health needs through evidence-based trainings for TPS staff. The FCS bridging the GAP project includes strategies which provide wraparound services through teams of mental health professionals (credentialed therapists, case managers, care coordinators, behavioral health aides and peer recovery support specialists) providing evidence-based practices through services delivered either via telehealth, in office, at home or at school. These wraparound services will include comprehensive, trauma-informed, patient-centered transitional plans and outpatient services. The bridging the GAP project will, therefore, ameliorate barriers to outpatient engagement, thereby reducing the risk of symptom exacerbation, relapse, hospital readmissions and suicide.