In recent years, a quiet revolution to integrate mental and physical health care has been growing nationally. Thanks to the perseverance of organizational leaders and a $1.6 million grant from The Substance Abuse and Mental Health Services Administration (SAMHSA)—Center for Integrated Health Solutions, that revolution has found its way to CMHC's doors.
The CMHC Wellness Center will open in February 2013, giving a medical home to 600 clients annually who meet medical criteria for services. All the benefits of primary care will be there including annual check-ups, prevention plans, sick visits, referrals to specialists, and a medical professional to talk to about any physical health concern.
CMHC's partner Cornell Scott-Hill Health Center (CS-HHC) will provide primary care at the Wellness Center. CS-HHC is a federally qualified community health center with a long history of serving New Haven neighborhoods. Thanks to the Wellness Center, mental and physical health teams at CMHC will be connected, delivering "integrated care" for better patient outcomes.
"This partnership is an innovative model of how health care can be integrated with behavioral health," said DMHAS Commissioner Patricia Rehmer. "Collaborations like this will become increasingly important as we continue to implement healthcare reform."
Jeanne Steiner, DO, CMHC’s Medical Director, and Chief Operating Officer Robert Cole, MHSA are co-leading the effort to create the Wellness Center at CMHC. For several years, they have been exploring different models for bringing primary care to the Center. The SAMHSA grant has provided necessary start-up funding; Cole says a key to the Wellness Center’s long-term success will be getting clients to use it.
Certainly, the need is great.
"Research has demonstrated that individuals with serious mental illness will die, on average, 25 years earlier than the general population," says Dr. Steiner. "Our Wellness Center will provide several services, including prevention, screening, and management of chronic medical conditions in an effort to reduce that trend."
"Health and wellness is the most critical issue facing the CMHC community," explains CEO Michael J. Sernyak, MD. "The Wellness Center will mean better access and quality of care for people who really need it."
Peer Wellness Coaches
Under the grant award, several full-time Peer Wellness Coaches will be hired and trained by CMHC to become patient navigators. They will support individuals with complex health needs who may have difficulty navigating the health care system alone. As full-fledged members of the integrated heath care teams, Peer Wellness Coaches, who are themselves in recovery from mental illness and/or addictions, will help patients take a more proactive role in self-care.
The use of Peer Wellness Coaches within a primary care setting represents an innovation in the field of mental health services.
Larry Davidson, PhD and colleagues at the Yale Program for Recovery and Community Health will evaluate two aspects of the Wellness Center: (1) whether bringing a primary care clinic into CMHC reduces costs, and (2) how well patients do with Peer Wellness Coaches.
Better Care, Lower Costs
A major driver of high costs in health care is the inappropriate use of acute care for health conditions that could be managed in outpatient settings. By offering patients the quality primary care they need, the CMHC Wellness Center seeks to reduce hospital and emergency room visits by people with mental health challenges.
CMHC, a community mental health center serving over 5,000 patients each year, is a collaborative endeavor of the Connecticut Department of Mental Health and Addiction Services (DMHAS) and the Yale University School of Medicine, Department of Psychiatry. DMHAS won the four-year SAMHSA grant to implement the Wellness Center at CMHC. Over time, the costs of providing primary care at the Wellness Center will shift to Medicaid; overall costs should be lower due to the preventative nature of care provided.
Most importantly, clients will benefit.
"It will make things more convenient for us," says Serena Spruill, a CMHC client and member of the Director's Advisory Council. "It should be easier and faster for us to get the results we need."
Cynthia Ferrari, also a Director's Advisory Council member, agrees. She already has primary care in the community but recognizes that not everyone does. With the Wellness Center, "we can do everything under one roof, with our primary care clinicians and psychiatrists in the same building," Ferrari says. "It will be easier for everyone."