Behavioral Health Monitoring & Consultation Services

Yale Behavioral Health (YBH) is a unit within the Yale Department of Psychiatry, which provides monitoring and consultation services for psychiatric hospitals, residential placements, and juvenile detention facilities. The focus is on organizations that are under a consent order at the state or federal level, are at risk of entering into such an order, or are striving to improve quality of care and efficiency of operations. The expertise encompasses mental health and substance use disorder treatment and populations across the lifespan.

YBH has a comprehensive approach to this process that involves three phases: (1) assessment, (2) improvement, and (3) maintenance of change. Using a team of skilled experts, it builds clear and concise action plans designed to improve quality; meet applicable regulatory, accreditation, and safety standards; and avoid or exit a consent order. Within a consent process, YBH will formally monitor and report on an organization’s progress, while simultaneously providing consultation services that support the entity’s efforts to effectively address areas of concern.

Personnel and Experience

For over a century, Yale faculty and affiliates have been consulting on and monitoring quality of care in behavioral health organizations across the nation. YBH has access to many highly qualified and experienced behavioral health professionals who are diverse with respect to discipline, area of expertise, and demographics. A unique team is assembled for each engagement to meet the specific needs of the organization and to address concerns of the involved regulatory, accrediting, and/or oversight bodies.

The Three-Phased Approach

Assessment Phase: The YBH team begins by conducting a full assessment of the organization, including an on-site visit and a thorough examination of policies, staffing, documentation, and operational workflow. Reports from regulatory, accrediting, and oversight bodies are reviewed in detail to identify areas of concern and issues regarding compliance. From this review the team assembles a list of priorities in the form of a Corrective Action Plan (CAP). The organization’s leadership and involved regulatory, accrediting, and oversight bodies are invited to comment on the draft CAP, which is then finalized.

Improvement Phase: The YBH team consults on implementation of the CAP, while simultaneously monitoring and reporting on progress in implementation. Individual Yale team members are assigned to oversee improvement and monitoring in specific areas of concern identified in the CAP. High risk issues are addressed first. Critical incidents are immediately reviewed, the implications for safety and quality improvement are identified, and the CAP is updated in response to this new information. Changes and improvements in written policy are viewed as necessary but not sufficient. The focus in on significant improvement in operational effectiveness, practice, staff competence, quality of care, and outcomes.

Maintenance Phase: This final phase is designed to document the progress accomplished and to promote sustainability regarding quality of care and compliance. The CAP is updated to address areas in need of further attention. Issues previously corrected are monitored to ensure that the improvement is maintained. Consultation on further improvement continues. The Yale team advises the organization’s leadership and other involved parties about the extent to which compliance with any consent orders has been achieved.

Contact Information

For additional information, contact Scott Migdole, Chief Operating Officer, Yale Behavioral Health and Assistant Clinical Professor, Yale University School of Medicine. He can be reached at scott.migdole@yale.edu or 203-927-4767.