Precision LTC Pharmacy

Building a Responsive, Accountable, Recovery-Focused System of Care

I wish to briefly describe what is on the horizon for the Adult Mental Health system in our state. The New York State public mental health system is among the most well-funded in the country, yet outcomes are of concern. In the middle are people who struggle with mental illness and want to lead peaceful and fulfilling lives. I do not believe anyone familiar with this mental health system is satisfied with the results of our collective efforts.

The positive news is we are beginning to come together to transform these resources into a more responsive, accountable, recovery-focused system of care. A restructuring process has begun with broad stakeholder involvement. Phase one of this is clinic reform. The goals here are to improve access to clinic services by reforming the approach to funding, and improve quality by providing incentives for positive outcomes, by refocusing oversight towards good clinical practice and by providing technical assistance to improve clinical competencies. Initial efforts in this area include wellness self-management, where over 100 agencies are engaged in learning collaborative’s, and a web-based curriculum for training in integrated dual disorder (MH/SA) treatment will begin this year.

Phase two of reform will focus on the more specialized and intensive services available for people living with serious and persistent mental illness. The goals here are to assist people to succeed in life (work, housing, school, friends, wellness). The approach will be more integrated, accountable care with all services coordinated from a single plan; more mobile services that meet people in their houses and community, responsive to resolving crises; close coordination with physical health care; and a strong emphasis on employment and education.

In December 2008, the Office of Mental Health (OMH) received a Substance Abuse and Mental Health Services Administration (SAMHSA) grant to research and design recovery centers which could be consumer operated, or have strong consumer involvement in service provision. Recovery centers, working in collaboration with treatment staff, will have the charge to assist and inspire people to move forward with recovery goals.

In many areas of the State, psychiatric centers are a major resource. The OMH psychiatric center directors have begun work to make these facilities more responsive to the needs of the broader mental health system. People who no longer need to be in the hospital are starting lives in the community. Access to many of these facilities has improved. In the coming year, OMH field office and facility directors will begin work with counties and other mental health providers to plan how the psychiatric centers can help fill service gaps in ambulatory care, collaborate as a system partner, and serve as a valuable resource to achieve the transformation we all seek.

Housing, too, is going through a change. More OMH resources are going toward integrated housing projects and we are partnering with providers to design more flexible, individual housing support services. Housing services will be a resource for broader system transformation.

In these times of tight budgets, it is encouraging that the mental health community in New York is coming together to redesign how we use our resources to move toward a more responsive, recovery focused system of care.

This article was reprinted with permission and appears in the new OMH News, located at: www.omh.state.ny.us/omhweb/resources/newsltr/2009/jan.html.

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