Project Grant H79SM086405

FAMILY & CHILDREN'S SERVICES CCBHC IMPROVEMENT AND ADVANCEMENT PROJECT - FAMILY AND CHILDREN'S SERVICES (FCS) WILL EXPAND RAPID ACCESS, CARE COORDINATION AND PROVIDE A MORE COMPREHENSIVE CCBHC APPROACH BY REDUCING TRADITIONAL BARRIERS TO CARE FOR VULNERABLE ADULT POPULATIONS (SMI/SUD/COD) AND THOSE EXPERIENCING A MENTAL HEALTH OR SUBSTANCE USE-RELATED CRISIS WITH AN EMPHASIS ON MINORITIES AND INDIVIDUALS RESIDING IN ECONOMICALLY DISADVANTAGED COMMUNITIES IN TULSA COUNTY, OKLAHOMA. PRIORITY ACCESS FOR SUBPOPULATIONS WHO HAVE TRADITIONALLY NOT ENGAGED IN MENTAL HEALTH SERVICES IN THIS REGION INCLUDE UNINSURED, UNDERINSURED, VETERANS, PREGNANT WOMEN, ASSISTED OUTPATIENT TREATMENT (AOT) OR COURT COMMITTED OUTPATIENT POPULATION (CCOP), LGBTQ IDENTIFIED, HOMELESS, AFRICAN AMERICANS, HISPANICS, AND AMERICAN INDIANS, AS THESE POPULATIONS HAVE THE MOST STRIKING MENTAL HEALTH DISPARITIES. FCS WILL SERVE ADULTS LIVING WITH SMI/SUD/COD WHO ARE DISCHARGED FROM URGENT RECOVERY CENTERS/OR ARE REFERRED BY CRISIS INTERVENTION SERVICES, AS WELL AS THE COURT SYSTEM (AOT/CCOP), AND IN NEED OF ENHANCED TRANSITIONAL SUPPORT TO OUTPATIENT BEHAVIORAL HEALTH CARE SERVICES. THIS PROGRAM WILL PROVIDE RAPID INTERVENTIONS, FOLLOW UP AFTER CRISIS SERVICES, AND DAILY STAFF HUDDLES. THE PROGRAM WILL BE DESIGNED TO ENGAGE HIGH-RISK CONSUMERS FOCUSING ON FIELD-BASED VISITS TO ENGAGE THE CONSUMER THROUGH EMBEDDED STAFF AT THE FCS URGENT RECOVERY CENTER, THE CONSUMER'S RESIDENCE, AND VARIOUS COMMUNITY PROVIDER LOCATIONS AND CRISIS OR COMMUNITY SETTINGS. THE TRANSITION FROM A CRISIS URGENT RECOVERY CENTER CHAIR, ENCOUNTER WITH MOBILE CRISIS SERVICES, OR FROM THE COUNTY COURT SYSTEM TO OUTPATIENT CARE POSES SUBSTANTIAL OBSTACLES AND RISKS TO SUCCESSFUL TREATMENT OUTCOMES FOR ADULTS WITH SMI/SUD/COD. RATES OF OUTPATIENT NON-ENGAGEMENT RANGE FROM 22% TO 90%, DEPENDING ON THE POPULATION OF FOCUS AND THE NON-ENGAGEMENT TIME PERIOD MEASURED. FOR FCS CRISIS CARE CENTER OUTPATIENT URGENT RECOVERY SERVICES (C2), 48%-80% FAILED TO ENGAGE IN OUTPATIENT SERVICES SEVEN DAYS AFTER DISCHARGE (2021). FAILURE TO ENGAGE PATIENTS IN OUTPATIENT SERVICES GREATLY INCREASES THE PROBABILITY OF MEDICATION NON-ADHERENCE, RELAPSE, SYMPTOM EXACERBATION, RE-HOSPITALIZATION, ARREST AND INCARCERATION, HOMELESSNESS, VICTIMIZATION, FAMILIAL VIOLENCE, AND INCREASED RISK OF SUICIDE (NAMI 2020). THE PROPOSED PROJECT PROVIDES MULTI-TIERED SOLUTIONS TO INCREASE HIGH RISK CONSUMERS' ENGAGEMENT IN OUTPATIENT CARE FOLLOWING A PSYCHIATRIC STAY IN A CRISIS URGENT CARE FACILITY (CHAIRS), CRISIS INTERVENTION SERVICE, OR COURT INVOLVED ENCOUNTER/COMMITMENT. THE PROJECT WILL AMELIORATE BARRIERS TO OUTPATIENT ENGAGEMENT, THEREBY REDUCING THE RISK OF SYMPTOM EXACERBATION, RELAPSE, HOSPITAL ADMISSIONS, PRIMARY HEALTHCARE DISPARITIES AND SUICIDE.