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The 86th Texas Legislature is right around the corner – set to begin January 8th. In gearing up for this session, we’d like to take a look at some of the valuable legislation that came out of the 85th session, progress made during the year and a half interim, and the anticipated issue areas coming up in January.

Find out more in our monthly newsletter Transparencies.

A report from the Children’s Mental Health Crisis Task Force recommends that to improve care for children the community needs to remove the stigma associated with mental illness, offer more crisis intervention options and better coordinate care.

Read the report here.

Integral Care is closely evaluating the various emerging technologies as well as how they may allow us to improve access, measure outcomes, develop best practices, and control costs. How do they work, what’s promising but unproven, and where are the possible drawbacks? Find out in our monthly newsletter Transparencies.

November 12, 2018

Crisis Text Line

Integral Care recently launched a collaboration with Crisis Text Line, a national organization that provides free, 24/7 crisis support via text, increasing access to crisis care for people in our community who prefer texting to talking. Since 75% of texters are under 25, the text line is an additional tool that helps youth and young adults who may be struggling. Here’s how it works:

 

  • An individual texts TX to 741741.
  • A trained Crisis Text Line counselor receives the text and responds quickly – within 5 minutes.
  • The Crisis Text Line counselor helps the individual stay safe and healthy using active listening and suggested referrals – all through text message, using a secure platform.

 

Crisis Text Line counselors are volunteers who go through rigorous training. A paid professional with an advanced degree in counseling, psychology or social work closely supervises them, monitoring every conversation. Additionally, supervisors have experience in crisis intervention.

 

Crisis Text Line is an anonymous service, which means they don’t know the location of the person reaching out for help. However, if a texter is at imminent risk of suicide, including ideation, plans, means or timing within 24 hours, a Crisis Text Line supervisor can activate emergency response and identify the location of the individual. Crisis Text Line will contact local law enforcement or EMS to perform a safety check on the individual. In this situation, local law enforcement or EMS might refer to Integral Care or involve our Mobile Crisis Outreach Team. Nationally, Crisis Text Line contacts law enforcement or EMS an average of 20 times per day.

 

Integral Care continues to provide immediate crisis support over the phone 24 hours a day, 7 days a week through our 24/7 Crisis Helpline at 512-472-HELP (4357). We are proud to partner with the Text Line, so that people who prefer not to pick up the phone have access to the support they need, when they need it.

Mental health crises are costly for individuals and our local systems. They can be draining emotionally and financially, and can result in life-threatening situations. A mental health screening is the first step to linking at-risk individuals with treatment options before a mental health issue becomes a mental health crisis.

 

Read more in our monthly newsletter Transparencies.

September 20, 2018

Anyone Can Save a Life

Suicide is preventable, yet it is one of the leading causes of death in our state. It affects all of us – regardless of race, ethnicity, age or gender. September is National Suicide Prevention Awareness Month, an opportunity to promote awareness and share resources to help save lives.

 

Read more in our monthly newsletter Transparencies.

August 23, 2018

A Milestone Moment

Over the past 25 years, we have witnessed changes and innovations that have improved health outcomes for people living with mental health issues, substance use disorders and/or intellectual and developmental disabilities. Changes in attitudes and policies have created a more progressive system for the people that we exist to serve. Integral Care has grown in this time to serve more than 30,000 people each year through more than 30 programs with a workforce of nearly 900 people. Leading this large network of dedicated and experienced staff is our CEO, David Evans. This month marks David’s 25th anniversary as CEO and we are thrilled to recognize this milestone.

 

Read more in our monthly newsletter Transparencies.

Integral Care is honored to be one of the few Certified Community Behavioral Health Clinic (CCBHC) pilot sites in the state of Texas. Through a rigorous application process, Texas Health and Human Services Commission (HHSC) selected us as 1 of only 8 sites (among 25 interested centers) that exhibited the highest levels of readiness to participate in the CCBHC certification process. Over the course of a planning year, Integral Care prepared to become a CCBHC through continued partnership with HHSC staff, and in October 2016 received HHSC’s certification.

 

Becoming a CCBHC pilot site has meant adopting new national guidelines that standardize operations for mental health, substance use, community based and physical health care services. CCBHC standards promote better access to high quality care for people with serious mental illness, those with severe substance use disorders, children and adolescents with serious emotional disturbance and those with co-occurring mental, substance use or physical health disorders. The CCBHC model puts an emphasis on the provision of 24-hour crisis care, culturally competent care for veterans, utilization of evidence-based practices, care coordination and the advancement of the integration of behavioral health and physical health care. As early adopters of CCBHC standards, Integral Care is positioned to help guide the nationwide policy.

 

CCBHCs are the future of care delivery in our evolving health care ecosystem. By working within the CCBHC model, we are positioning Integral Care for better funding opportunities at the federal, state, and local level. In March, Congress passed an omnibus spending bill allocating $100 million to CCBHCs. The Substance Abuse and Mental Health Services Administration (SAMHSA) will be distributing those funds via a grants process sometime next month. New CCBHC funding is anticipated to make a big difference in the area of treatment for opioid disorders.

 

Ultimately, operating as a CCBHC improves care delivery and thus improves the overall health of the people we serve.

Integral Care is excited to announce our FY17 Annual Report. Learn about the work we did last year to support adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities.

Integral Care has released a brand new directory of services. This directory provides descriptions of Integral Care’s many programs and services, plus a map of our locations and other helpful info for our clients and community. Look for English and Spanish versions in our clinics next week.

AUSTIN, Texas — Of the more than 7,000 people who experience homelessness in Travis County each year, many have complex health problems as diverse as heart disease and asthma. To help address these persistent challenges, Dell Medical School at The University of Texas at Austin, CommUnityCare Health Centers and Integral Care, Travis County’s mental health authority, are joining forces to launch an innovative, federally-funded mobile care team that serves homeless individuals where they are.

 

The collaboration, which is funded by a five-year, $2.3 million grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), will support homeless men and women who have a chronic medical condition along with serious mental illness and/or substance use disorder. The mobile, multidisciplinary team will be staffed by qualified health care providers who integrate comprehensive primary care, mental health care, substance use treatment, intensive case management, and wraparound services such as housing assistance and social programs enrollment into a continuum of care with one single team.

 

“Homeless Austinites living with multiple complex medical problems are among the most vulnerable and difficult to reach members of our community, but we believe that our innovative approach can work,” said Dell Med’s Tim Mercer, M.D., MPH, assistant professor in the departments of Population Health and Internal Medicine, who is the project director for this grant. Efforts to effectively treat this population require careful coordination among advocates and organizations working in Austin’s health ecosystem, he said.

 

“Our goal is to fill gaps in care by leveraging the existing strengths and infrastructure of the three collaborating organizations in a whole new way,” Mercer said. It’s also essential to coordinate efforts with other local organizations, such as the Ending Community Homelessness Coalition (ECHO), he added.

 

A 2017 Point-in-Time Count performed by ECHO found that 2,036 Austin residents experience homelessness on any given night, of whom 553 are chronically homeless, 345 have a substance use disorder and 519 experience serious mental illness. It also found that 61 percent of people experiencing homelessness access health care through an emergency room or not at all.

 

Meeting People Where They Are

 

One key design feature of the mobile model is that it allows the team to bring care to patients where they live, unlike the traditional model of requiring patients to seek services in clinics or hospitals to address their health needs.

 

“Normally the burden is entirely on the patient — they have to make appointments, figure out how to get a ride, go to the pharmacy, get their labs processed — they are constantly forced to jump through hoops,” said Audrey Kuang, M.D., clinical director of the homeless health care program at CommUnityCare and assistant professor in the departments of Internal Medicine and Population Health at Dell Med. “It’s tough enough for the average person, but for someone struggling with mental illness or chronically sick or worrying about their next meal, those hoops can be insurmountable obstacles,” she says.

 

Equipped with mobile medical supplies, laptops to access medical records on site, and well-honed “street medicine” engagement tactics, the team remains unfettered by the need for a building or an exam room to care for patients.

 

“We can meet with clients on the street, a park bench, under a bridge — wherever we need to be to serve them best,” says Kuang.

 

When more complex care is needed, the mobile team can also see patients in one of CommUnityCare’s 24 clinics or Integral Care’s four integrated mental and primary care clinics in Travis County.

 

The community-based mobile care team will consist of at least six health professionals, including:

 

  • A primary care physician or nurse practitioner
  • A mental health care psychiatrist or nurse practitioner
  • A licensed chemical dependency counselor
  • A nurse case manager
  • A qualified mental health professional case manager
  • A peer navigator

 

An important part of this community-based program is that it relies on the complementary strengths of the organizations involved. Integral Care has been providing outreach and recovery services to people experiencing co-occurring homelessness, mental illness and substance use disorder for over 20 years. Integral Care also partners with the Austin Police Department and Austin-Travis County EMS to connect individuals living on the street to housing, mental and primary health care and alcohol and drug treatment as part of the Homelessness Outreach Street Team. CommUnityCare, part of Central Health’s enterprise, provides primary care and standard case management services to the homeless as well. Dell Med’s population health experts will augment these existing resources through direct care, coordination among the partners, and research and evaluation efforts.

 

“We are excited to expand our partnership with Dell Med and CommUnityCare to further support our city’s homeless community,” said Darilynn Cardona-Beiler, director of adult behavioral health systems at Integral Care. “This grant allows us to bring our expertise together and innovate in a unique and effective way. Together, we’re meeting people where they are in the community — providing integrated primary care, mental health care and much needed substance use treatment on the streets of Austin.”

 

Measuring Success


In addition to serving as orchestrator of the project, researchers from Dell Med’s Department of Population Health will work to measure the success of the effort. Its data integration division will coordinate information from Integral Care’s and CommUnityCare’s electronic health systems and directly from patients to evaluate effectiveness and identify opportunities for improving and expanding this care model.

 

“By incorporating research into this project, we will be able to understand if this approach to caring for our city’s homeless works and can pay for itself, by reducing hospital and ER visits, for example, and if it can be scaled and replicated to improve the health of communities across the nation,” said William Tierney, M.D., professor and chair of Dell Med’s Department of Population Health.

The Chronicle’s year-end accounting of the best in Austin has named MCOT the “Best Mobile Mental Health Heroes” in the city. MCOT can respond to a mental health crisis whenever or wherever it occurs-and provide medication services and counseling for up to 90 days, with a goal of connecting individuals with the long-term resources they need to recover.
We are grateful to the Austin Chronicle for recognizing the work of this dynamic team. Full coverage is available here.

The HOST team is a partnership between Integral Care, the Austin Police Department, Emergency Medical Services, Downtown Austin Community Court and the Downtown Austin Alliance. An approved increase of funding will cover the cost of a certified peer specialist/peer recovery coach and allow more funding to address immediate needs, like obtaining official ID documents and bus passes.

Find out more in this report from KXAN.

“Mental health services in Austin ISD is an essential part of educating the whole child,” said Tracy Spinner, district director of health services. “We are thankful for dedicated partners like Integral Care who have stepped up to continue services for our students at 16 campus mental health centers. While we are one step closer to supporting our students, the need for additional funds is still present and we are continuing to meet with potential partners to fully fund these services.”

The Austin school board Monday night approved an agreement with Integral Care to keep 16 campus mental health centers open this school year. Read more in the Statesman.

U.S. News and World Report shined a spotlight on Integral Care’s integrated care services. The article features an Integral Care client who lives with bipolar and obsessive-compulsive disorders and benefits from integrated mental and physical health care as well as wellness services. Our client says, “It has really built me up to be a better woman.” The story also features our partners Dell Medical School and CommUnityCare.

Integral Care’s Systems Chief Medical Officer James Baker wrote an article for this month’s TexasMedicine about the ways our state can focus on prevention and early detection of mental illness.

 

By James G. Baker, MD, MBA

 

It is far too common in psychiatry for diagnosis to first come in a crisis visit to the emergency department, the equivalent of diabetes being first diagnosed as ketoacidosis. That is why I am very persuaded by the argument that we should focus on early detection and treatment in mental health, just as in other medical specialties.

 

What if our medical association and our local medical societies took the lead in the development and implementation of strategic population mental health initiatives across the state focused on early detection and intervention of mental illnesses? Our shared vision could be a statewide population mental health initiative with four parts:

 

Routine screening for depression, anxiety, and post-traumatic stress as a part of every outpatient clinic visit in Texas. Mental health screening could ― and should! ― be just as routine as temperature, pulse, and blood pressure screens for every adult in Texas, whether care is provided in the public or private sector. As an example, The University of Texas Southwestern’s Madhukar Trivedi, MD, has an iPad software program, VitalSIgn6, that screens for depression and can be modified to screen for other common mental health challenges.

 

Routine substance-use screening as part of physical exams for every teenager and adult in Texas. The NIDA Modified Assist (for adults) and the CRAFFT (for adolescents) are examples of quick, easy-to-use screening tools. Significant reductions in alcohol and substance use can result when screening is followed by a nurse or social worker offering brief, evidence-based intervention at the same doctor visit.

 

Easy access to evidence-based, first-episode psychosis treatment and research protocol for every newly diagnosed patients in Texas. Early and aggressive treatment in programs like RA1SE have been shown to improve markedly the outcome of patients with schizophrenia and other psychiatric disorders that include psychotic symptoms. Its availability currently is limited, but detection and early treatment are just as important with schizophrenia as they are with cancer.

 

Easy access to mental health first-aid training for everyone in Texas. Mental Health First Aid is a training course started in Australia 15 years ago that is now available statewide for anyone in the community, including first responders. The training reduces stigma, and, just like CPR, Mental Health First Aid has the potential to save lives. Our goal could be to train 750,000 people statewide.

 

Perhaps our medical association and local medical societies could partner with medical school departments of psychiatry, with local mental health authorities, and with local and statewide philanthropic organizations to demonstrate quick and quantifiable success in our four-part, population mental health initiative. Armed with that data, we could approach policymakers with strategies to improve access and quality of mental-health and substance-use services to everyone in our state, especially to the poor.

 

The potential impact on our patients and our communities ― and on each one of us ― is huge. As a mother, father, son, or daughter, you are just as likely to have family affected by mental health as by cancer ― up to one in three Texans has a mental health and/or substance use disorder. As a taxpayer, you help fund at least $1.4 billion in emergency department costs from mental illnesses presenting in crisis.

 

Each of us now knows that mental illness is medical illness, just like diabetes, cancer, or cardiovascular illness. And each of us knows that contemporary mental health care is rooted in science. Next, we must insist upon prevention, early intervention, and aggressive treatment for people who endure these potentially devastating disorders. When all that is required for early detection is a couple of questions asked while taking a pulse, then collectively we must insist that those questions get asked.

 

James G. Baker, MD, MBA, is a member of the Texas Medical Association Council on Science and Public Health. He also serves as associate chair of clinical integration and services in the Department of Psychiatry at The University of Texas at Austin Dell Medical School and as systems chief medical officer for integral care, the community mental health center for Austin and Travis County. Dr. Baker is a Distinguished Life Fellow of the American Psychiatric Association and a recipient of the National Alliance for the Mentally Ill Exemplary Psychiatrist Award as well as the Mental Health America of Greater Dallas Pamela Blumenthal Memorial Award.  

 

The commentary article was originally published on the Texas Medical Association’s website here as part of TMA Publication TexasMedicine February 2018.

The Austin Chronicle highlighted how Integral Care works closely with community partners to support the mental health needs of Travis County, particularly those experiencing a mental health crisis. “Anyone can experience a mental health crisis,” said Laura Wilson-Slocum, Integral Care Practice Administrator. This article explores the variety of crisis services Integral Care provides our community – the Judge Guy Herman Center for Mental Health Crisis Care provides short term crisis care in an overnight setting, our Mobile Crisis Outreach Team co-responds with the Austin Police Department and EMS to provide community-bases crisis care, and our Psychiatric Emergency Services provides mental health urgent care seven days  a week. Read the article here.

November 15, 2017

24/7 Crisis Helpline

Spectrum News recently highlighted the impact of our 24/7 Crisis Helpline. They interviewed Ca’Sonya, an Austinite who used the Helpline to get through her darkest hour. After Ca’Sonya lost her husband, she decided to make a life-changing phone call to get the support she needed. “The hardest step is just starting picking up the phone,” said Nicole Warren, Integral Care Helpline Program Manager. “Once you pick up that phone, you’ll find someone who is passionate and dedicated to what we do here.”

Integral Care’s Helpline provides around the clock crisis support and access to all of Integral Care’s programs and services for adults and children, including appointments and billing. Our Helpline recently added free interpretation services in 15 language to meet the needs of our growing and changing community. We have trained medical interpreters who speak Spanish, Chinese, Vietnamese, Arabic, Korean, Filipino, Russian, German, French, Urdu, Farsi, Japanese, Hindi, Gujarati, and Napali. Learn more about the Helpline.

August 30, 2017

During a traumatic event, mental health support is more important than ever. KVUE covered the developing story of Hurricane Harvey and its emotional effect on evacuees and first responders. “It’s critically important for mental health professionals to be available to those in need, to give guidance and offer a sense of safety and security,” said Dr. Kathleen Casey, Integral Care’s Director of Clinical Innovation and Development.

Read More

August 8, 2017

KXAN highlighted Integral Care’s first of its kind Judge Guy Herman Center for Mental Health Crisis Care. The Herman Center will offer the right level of care at the right time, reduce cost of care and improve health outcomes for patients. “The idea is most mental health crisis can resolve in the first 48 hours of them beginning, so we want to quickly stabilize people so we can get them on that path to recovery and back out into the community as soon as possible, avoiding a hospital stay which tends to be lengthier and more expensive,” said Laura Slocum, an Integral Care Practice Administrator. The Herman Center is currently only accepting internal referrals from Integral Care crisis services. It’s not appropriate for walk-ins or self-referrals. To learn more about the Herman Center, click here.

Read More

Mental Health First Aid (MHFA) is an 8-hour class that provides people the basic tools to help someone who might be developing a mental health problem or experiencing a mental health crisis. MHFA can save a life, just like CPR can save someone who is having a heart attack.
This training is open to the community and gives people the tools they need to help friends, family, colleagues, and community members. By the end of the session, participants will be able to identify warning signs and risk factors for mental illness; recognize signs and symptoms of depression, anxiety, trauma, psychosis, and substance use disorder; and implement the 5-step action plan to help someone showing signs of mental illness or experiencing a crisis.
To sign up for MHFA, please see the event listing on Eventbrite.

Tables and Sponsorships are still on sale.

 

Join us this year as we honor Dr. Clay Johnston and highlight the partnership between Dell Medical School and Integral Care.

 

Funds raised this year will go to provide the latest evidence-based best practices that are the critical tools for building recovery for persons with intellectual and/or developmental disabilities who are experiencing a mental health crisis.

 

New Milestones Foundation raises funds to support Integral Care in meeting the needs of adults, families, and children in our community with mental illness, substance abuse disorders and intellectual and developmental disabilities. We accomplish this by bridging the gaps between what government funds and what enhances Integral Care programs and services and between what we have today in practice and what might be promising practices for the future.

 

Tickets to event

 

Integral Care is now offering weekly Mental Health First Aid (MHFA) classes in Austin and Georgetown. MHFA is a one-day training that teaches people how to help someone who may be experiencing a mental health crisis or showing signs of mental illness or substance use disorder. Thanks to a grant from the St. David’s Foundation, no one will be turned away. However, a donation of $10 is welcome.

MHFA can save a life, just like CPR can save someone who can’t breathe or is having a heart attack. Register today.

Last week, Integral Care hosted a Community Forum on Rebuilding Health and Well-Being After Trauma. It was an impactful event featuring Dr. Elisa Borah of UT’s Steve Hicks School of Social Work, Seanna Crosbie of Austin Child Guidance Center and Dr. Valerie Rosen of UT’s Dell Medical School. The panel also included someone with lived experience who courageously shared her story. Our experts shared information about direct and indirect trauma and resources that support recovery.

 

 

To build upon the information shared at the forum, we recapped the event in our new podcast – This is Integral, which explores topics that are integral to the health and well-being of our community. Please join Integral Care’s Dr. Kathleen Casey, Director of Clinical Innovation and Development, and David West, LCSW, LCDC, Integrated Care Clinic Practice Manager, as they discuss key takeaways from the forum. They’ll share favorite moments from the panel and talk about Integral Care’s approach to supporting individuals impacted by trauma.

 

Please find resources from our panelists below.

 

Austin Child Guidance Center

Seton Behavioral Health Care Restore Program

Trauma-Informed Care Consortium of Central Texas

Veteran Couples Connect Program

Veteran Spouse Resiliency Group Program

 

We look forward to seeing you at our next Community Forum in the spring.

July 17, 2017

On July 17th, over 100 people attended the Ribbon Cutting Ceremony for the Judge Guy Herman Center for Mental Health Crisis Care. Senators, Representatives, City Council members, law enforcement, our partners St. David’s Foundation and Central Health as well as members of the community were all present to mark this historic occasion.

The Herman Center will provide short term, emergency psychiatric crisis care for adults in Travis County. It will support our community by providing an alternative to incarceration and in-patient care, and will offer the opportunity to ensure that individuals whose primary issue is mental health have an appropriate and safe place to be stabilized, assessed and treated. The goal is to quickly resolve the immediate crisis so the individual can return home or transfer to another Integral Care residential program for ongoing support and recovery. The Herman Center offers the right level of care at the right time while reducing the cost of care and improving health outcomes for patients. Primary referrals to the Herman Center will come through law enforcement and health care providers like emergency rooms. The Herman Center is not suitable for walk-ins or self referrals. To learn more about the services of the Center, click here.

Thank you to all of our community partners, especially St. David’s Foundation and Central Health, for making this much needed service available in the community. St. David’s Foundation funded the project with a grant totaling almost $9M and Central Health made the land available via a low cost (virtually free) long-term lease, valued at $1.2M.

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