Posted: Monday, August 22, 2016 12:15 am
Local behavioral health services were rated from slightly above to slightly below average in a survey of clients and providers conducted by two research groups.
FaithHealthNC and Community Health Assets Mapping Partnership released last week its report that focused on Davidson, Davie and Forsyth counties. The research was paid for by the Winston-Salem Foundation.
Researchers conducted workshops in the counties on April 1-2 that drew a combined 34 providers and beneficiaries, whom they referred to as “seekers.”
Survey participants were asked to rate the efficiency of six community-service assets in six categories.
The assets were retail providers, the faith community, local parks where activities are held, hospitals and clinics, community centers, and shelters.
They were rated from one to five (five being the highest score) on transportation challenges, financial resources, provider competence, case coordination, assistance with client self-management of needs, and peer and community support. Some assets were not rated in all categories.
The asset with the best overall score was local parks at 3.75, followed by community centers at 3.54, faith community at 3.5, shelters at 2.83, retail providers at 2.62, and hospitals and clinics at 2.58.
“The workshops were designed to identify and align assets both tangible, such as a clinic, and intangible, such as the acceptability of care or how it is delivered,” said Teresa Cutts, an assistant professor of social sciences and health policy at Wake Forest University. Among Cutts’ specialties are evaluating program and population needs.
“Seekers identified peer and community support, self-management, financial resources, provider competence and care coordination as the top factors contributing to optimal behavioral health,” researchers said.
Topping their list of challenges were lack of respect, lack of coordination of services, self-direction of resources, and lack of motivation.
“Providers identified person-centered care and accessibility as the top factors contributing to optimal behavioral health,” researchers said.
For more than 10 years, local mental health advocates have criticized providers and overseers of behavioral health services for minimizing their outreach and awareness efforts to those in need.
“It seems like providers think they (seekers) have everything they need, but people just need to access it better, whereas the seekers are saying that there is something missing,” researchers said.
Shortly before CenterPoint Human Services was acquired by Cardinal Innovations Healthcare Solutions on June 1, CenterPoint began a series of public service announcements and billboard marketing to raise awareness of its 24-hour customer-service call center.
Cardinal agreed to proceed with CenterPoint’s plans to open a 20,000-square-foot building off Highland Avenue and U.S. 52 in Winston-Salem for inpatient and residential psychiatric care with up to 16 beds. The agency will pay a $1 annual lease.
“There are a lot of things that can be better tied, but we need a framework, and we really don’t have one,” the researchers said. “The group suggests creating a mixed-media approach for seekers to have various entry points into behavioral health resources.”
Laurie Coker, a local and statewide advocate and former CenterPoint board member, said seekers “felt that respect in relating to them was the No. 1 value.”
“They cited a lack of provider competence with regard to how they engage and relate to clients.
“Service seekers placed a high value on peer-to-peer support and on planning their own path to health, instead of having someone else plan their services or health supports for them.”
Coker said the main transportation concern she hears is providing a ride when a seeker has a non-scheduled or emergency need.
Billy West, president of DayMark Recovery Services Inc., said that while the report contained a small sample of providers and seekers, it “did a good job of pointing out the need for greater inclusion with greater integration of behavioral and physical care.”
“Transportation appears that it will forever be an issue to varying degrees,” West said, although progress is being made with extended service hours, Medicaid-paid transportation options and vouchers.
West said that the goal of “treating the whole person is easier said than done.”
“If this was a viable business, the hospitals would have done it a long time ago. Some location models of integrated care are big money losers. Without Medicaid expansion, I think it will continue to be, for the number of indigent patients is simply too high.”
Cutts said the researchers have set short-terms goals of increasing community engagement with seekers.
“One key way they intend to do that, through FaithHealthNC education, is by training laypersons in congregations and broader communities in mental health first aid and community resiliency models (in order) to build their capacity to be part of a broader safety net,” she said.
Cutts said participants at Wednesday’s Forsyth County Mental Health Collaborative presentation “were keen to continue the momentum to do something vs. hold more meetings or conferences.”
“There were complaints about the lack of family members involved in the workshops.”
David Mount, chief executive of Mind Body Institute Beyond PLLC and a CenterPoint board member, said seekers would view community services in a more positive light if there were improvements in care coordination acceptability and transportation.
On the other hand, Mount said some seekers view providers and their overseers as “disinterested in working to cultivate a more inclusive voice, representing diverse perspectives.”
“I got the very real sense that people feel as though they have their hands tied behind their backs while trying to navigate the potential threats of advocacy fatigue and misaligned communications with Cardinal Innovations community operations.
“In its first 60 days or so, Cardinal Innovation and (local) mental health advocates find themselves potentially drawing lines in the sand, largely due to the perception of a one-size-fits-all community engagement strategy.”
Article Reference: Report Rates Local Behavioral Health Services