Read more in our monthly newsletter, Transparencies.
The Austin Chronicle published an article focused on how Austin women are dispelling stigma and moving mental health issues forward. The article features Deborah Rosales-Elkins, Peer Support Specialist, and Ellen Richards, Chief Strategy Officer, as well as key Integral Care partners from NAMI Central Texas and Travis County Sheriff’s Office. Read it out here or grab the 7/4 issue off the stands.
The 86th Texas Legislative Session has come to a close with over 4,500 bills and resolutions passed. Legislators came together, strong in their bipartisan commitment to various issue areas including mental health, substance use disorder and intellectual and developmental disabilities (IDD).
Read more in our monthly newsletter, Transparencies.
On June 19, St. David’s Foundation awarded Integral Care $1.6 million to support operations at the Judge Guy Herman Center for Mental Health Crisis Care, which provides short-term emergency psychiatric crisis care for adults in a secure, protected residential environment before making a safe return to the community.
St. David’s Foundation has been instrumental in bringing this essential service to our community. In 2014, the foundation awarded Integral Care a capital grant to build a new mental health crisis center that would reduce strain on local emergency departments, reduce costs of care, and divert individuals experiencing a mental health crisis from jail. Three years later, Integral Care opened the Herman Center.
Since opening in 2017, the Herman Center has filled a critical gap in the local mental health safety net by offering additional psychiatric emergency beds in our community for those who do not require inpatient treatment. During a short-term stay, people can access services including crisis assessment, crisis stabilization and extended observation, medications, individual and group therapy, peer services, nursing services, case management, discharge planning, and linkage to ongoing care and additional community resources.
From July 2018 through May 2019, the Herman Center served 1,747 individuals, the majority of whom were referred by emergency departments or law enforcement. With the Herman Center in our community’s continuum of care, we can ensure that psychiatric crisis treatment is always available in the most appropriate and cost‐effective setting.
Learn more about St. David’s Foundations 2019 summer grants here.
Lead Editor: Nathaniel Hall, Assertive Community Treatment (ACT) Team Peer Support Specialist
Bill Newcomb is the peer specialist for Integral Care’s Judge Guy Herman Center for Mental Health Crisis Care. Nathaniel Hall interviewed him.
Nathaniel: Part of a peer specialist’s job is mentoring. What does that include?
Bill: Mentorship is a relationship in which a more experienced or more knowledgeable person helps to guide a less experienced or less knowledgeable person.
Sometimes peer specialists can look like teachers or coaches or sponsors depending on what we’re doing. Peer specialists are experts in recovery and resilience. We’ve managed to get our life back on track after suffering a major disruption. Sharing our recovery story and what we’ve learned along the way is a major qualification for our job.
Nathaniel: Where do peer specialists get their expertise?
Bill: Life. My expertise comes from having lived with mental illness and all the associated challenges it presents. Peer specialists have all had major life disruptions due to mental illness and have survived and overcome. We use ourselves as examples, proof that people can, and do recover.
Recovery to me isn’t a destination, it’s a journey. One of my favorite quotes relating to peer support is “The first to help you up are the ones who know how it feels to fall down.”
Nathaniel: What does a peer specialist focus more on – recovery and wellness or illness and disease?
Bill: Recovery and wellness without a doubt. One of the most important jobs a peer specialist has is to tell our recovery story. This is very different from a “war story” in that the focus is on how we got through the tough times. How we survived. What helped us get better and what didn’t. This doesn’t mean we shy away from talking about the bad stuff, the illness and its impact. It’s the difference between just remembering the hard times and learning from the past.
One thing I’ve seen over the years is that people who struggle with mental illness often have a hard time having hope. Spending too much time focusing on problems can make them seem worse and lead people to a sense of hopelessness or powerlessness. Focusing on positive actions people can take gives them more of a sense of control and empowers them. Having ways of “fighting back” help people to not feel like helpless victims.
One of the things I do a lot of groups on is coping skills. The number one way to take a break for me is “pet a furry creature.”
Nathaniel: What does “peer advocacy” mean?
Bill: It’s frequently the case that people dealing with mental health challenges are told what their recovery should look like by family, friends or medical professionals. Peer specialists can help people define what they want their recovery to look like and help them to advocate for treatment that supports their goals.
Recovery means different things to different people. I define my own recovery as being able to live a happy and productive life, but I can’t impose my definition on anyone else. For some people, it might just mean staying out of psychiatric hospitals. That was my main goal when I was newly diagnosed. Promoting self-determination is literally the first principle in the certified peer specialist code of ethics.
Another way peer specialists help advocate for our clients is navigating the mental health system itself. Sometimes this can mean translating the language used by specialists, for example “doctor speak.” Sometimes it can mean aiding someone in finding help or resources.
The Herman Center offers adults emergency mental health care in a safe overnight facility. Staff help adults who are in crisis by providing medical support, emotional support, medicine and connection to ongoing services. The Herman Center does not accept walk-ins. Referrals come from law enforcement and healthcare providers, like local emergency departments.
May 31, 2019
By Karen Ranus of NAMI Central Texas and Ellen Richards of Integral Care
Being Superwomen – juggling family, career, relationships, community service and aging parents – puts us at risk. Trying to do it ALL, women often forget to put themselves on the “to do” list. Neglecting to take care of ourselves can and does impact our mental health.
Research shows that women are twice as likely as men to experience depression, anxiety and PTSD, and twice as likely to attempt suicide. Yet, few of us recognize mental health is just as important as physical health. One in five people – women, men and children – experience a mental health issue in their lifetime. Mental illness is actually far more common than cancer. It is a brain-based disorder, deserving the same care, treatment and respect as a physical illness. But we still have work to do when it comes to bringing mental illness out of the shadows.
Mental Health Month and National Women’s Health Week are recognized in May, creating an opportunity to raise awareness and share resources. If you or a female relative, friend or colleague experiences a mental health issue, here are things you can do:
- Seek help from a professional. Help is available and recovery is possible. Integral Care has a 24/7 Helpline (512-472-HELP/4357) for anyone who needs immediate emotional support – even if you’re just having a bad day. Mental health professionals are available around the clock to offer help without judgement and connection to services like integrated mental and primary health care and counseling.
- Take a free class or join a support group with NAMI Central Texas. NAMI supports individuals who experience a mental illness and their family members as they move toward recovery. People come together to connect, learn and share resources. Learn more at NAMICentralTX.org.
- Share your story. When women share their stories, we have the power to shift the conversation around mental health, create change in our healthcare system and improve mental health care for everyone. Being open about our own struggles empowers our community to recognize and talk about mental health without shame or stigma.
- Be compassionate and offer support. Just as you would reach out to someone diagnosed with cancer, reach out to someone experiencing a mental health issue. Share food, send a card, drive them to an appointment. Take Integral Care’s free Mental Health First Aid class to learn how to help someone experiencing a mental health issue or crisis. Register at integralcare.org/MHFA.
As we are told before taking off for a flight, “put on your oxygen mask first before assisting others.” Protecting our health and well-being are essential for women to continue to thrive. Women strengthen our community when we take care of ourselves just as we take care of others. Tending to our mental health is as important as our physical health. With access to quality mental health care and connection to a strong support network, we build health and well-being and become a more resilient community.
Karen Ranus is the Executive Director of NAMI Central Texas, the local chapter of the National Alliance on Mental Illness. Learn more at NAMICentralTX.org.
Ellen Richards is the Chief Strategy Officer of Integral Care, the Local Mental Health and Intellectual and Developmental Disability Authority for Travis County. Learn more at IntegralCare.org.
May 21, 2019
I am pleased to announce that Integral Care’s Fiscal Year 2018 (FY18) Annual Report is now available. I invite you to learn about the work we did in 2018 to support adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities (IDD).
As I reflect on last year, the word integration comes to mind. Integral Care believes in serving the whole person through integrated care. We believe that community systems and partners must collaborate at all levels, integrating their expertise, to advance the whole health of our community. In FY18, Integral Care partnered with the City of Austin, Travis County and Central Health, criminal justice, first responders, school districts, non-profit community-based organizations and healthcare providers to strengthen our local systems, improve access to care, and raise awareness around issues of mental health, substance use disorder and IDD.
Together, we are helping Travis County thrive and are moving closer to our vision of Healthy Living for Everyone.
Chief Executive Officer
May 6, 2019
Women are twice as likely as men to experience depression. Twice as likely to attempt suicide. The differences in how women experience mental health are real. Research identifies disparities between men and women in terms of risk, prevalence, presentation and treatment sought and received. For this month’s Transparencies, our Chief Strategy Officer, Ellen Richards and NAMI Austin’s Executive Director, Karen Ranus, talk about women’s mental health and how our community is addressing mental health issues.
Read more in our monthly newsletter, Transparencies.
April 19, 2019
The 86th Texas Legislative session is in full swing, with less than two months remaining. With over 7,500 bills filed, legislators are working hard to address a wide range of issue areas – from substance use disorder to mental health in schools. We’re following the progress at the Capitol and here’s the news worth noting.
Read more in our monthly newsletter, Transparencies.
March 27, 2019
Travis County’s robust economy has not come without its challenges. Our recent growth is greater than nearly any other large metro area in the country, and our human services infrastructure must innovate to keep pace. Of particular priority is increasing accessible and affordable treatment for substance use disorder in our community.
In general, funding for substance use treatment services is lacking. For the Travis County community, service availability has decreased in recent years due to funding issues. For those who cannot afford the high cost of private pay services and medication, this results in waitlists for services and limited access to medications. To complicate this further, individuals are often dealing with more than just a substance use disorder diagnosis.
“Home is where one starts from.”
Terrace at Oak Springs is Integral Care’s newest permanent supportive housing community. 50 individuals who are experiencing homelessness will have a safe place to call home, helping them on the road to recovery.
Many of the future residents have been living on the streets with nothing but what fits in a backpack. You can provide household essential items exclusively for Terrace at Oak Springs – kitchen tools, bathroom supplies, linens and more — to help make the apartments feel like homes.
We have partnered with COCObundle, a local social enterprise that has curated the registry of household goods. Once a bundle is purchased, COCObundle handles the rest—from stocking the products to creating welcome packages for each of the 50 residents to delivering the items to Terrace. When new residents arrive on move-in day, they already will have welcome packages in their unit.
To donate a bundle for a future resident, simply visit the Integral Care campaign on the COCObundle website and select your preferred bundle.
In lieu of a bundle, you can also make a donation to support the future residents of Terrace at Oak Springs.
June 10, 2019
Integral Care spoke with FOX 7 Austin about Post-traumatic Stress Disorder Awareness Month and the services we provide. Integral Care offers Mental Health First Aid training for Military Members, Veterans and their Families. Find out more here.
A home means recovery from homelessness, mental illness and substance use disorder. When people have a safe place to live, appropriate support services and the tools they need to achieve well-being, recovery begins and they can reach their full potential and contribute to their community.
May 22, 2019
Texas Health and Human Services Commission has committed $1.9 million to support homeless services, including expanding shelter services and shelter redesign, increasing access to mental health and substance use services for families experiencing homelessness, and supporting clinic operations and the expansion of housing services at Terrace at Oak Springs. Set to open in summer 2019, this new permanent supportive housing community includes 50 fully furnished, single occupancy efficiency apartments and an onsite integrated health care clinic – 3000 Oak Springs Clinic. Features include onsite staffing 24 hours a day, onsite laundry facility, outdoor green space, community room with library, computers, and internal and external security cameras. Terrace at Oak Springs is modeled after other successful programs across the country and the first of its kind in Central Texas.
The 3000 Oak Springs location provides integrated primary health care and mental health care to residents of the apartment community. Services include counseling and case management, drug and alcohol treatment, exercise and nutrition programs, medication management and support, employment services, and assistance accessing benefits. Clinic services are also available to adults in the community who are eligible for Integral Care services. The clinic will be open 8 AM to 5 PM Monday through Friday, and will offer scheduled appointments and a limited number of walk-in appointments. Community members will be able to access clinic services through the same intake and assessment process that Integral Care uses for all of its services.
Episcopal Health Foundation has awarded Integral Care $1.5 million to expand our clinical services and implement a new financing and collaborative infrastructure. As our interdisciplinary care teams research new interventions in our clinics, we can demonstrate improved health outcomes and reduced costs of care to managed care organizations and develop a case for a value-based payment structure. Partnering with Episcopal Health Foundation will help us create the infrastructure for this new payment system while providing us flexibility to continue our clinical work by bridging funding streams.
Our new Integrated Practice Unit at Dove Springs, an expansion of services offered by Dell Medical School and Integral Care at the Bipolar Disorder Center at UT Health Austin, will serve as the pilot site for this initiative. Later this year, Integral Care will bring this collaborative approach to yet another clinic – our 3000 Oak Springs Clinic, which is part of the forthcoming Terrace at Oak Springs permanent supportive housing community.
Integral Care’s integrative, team-based approach provides a strong foundation for implementing a value-based payment structure, which relies on collaboration and coordination throughout the cycle of care. By showing the improved health outcomes and reduced care costs of this care delivery model, we can collaborate with managed care organizations to create a value-based payment system that focuses on improving quality of care, rather than increasing quantity of services.
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.”
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.
November 14, 2018
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.
June 13, 2019
Join us for an update on Integral Care’s strategic plan and identified priorities. David Weden, Integral Care’s Chief Financial Officer, will provide an outline of our current budget and talk about what it takes to implement our Fiscal Year 2020 budget.
November 15, 2018
October 15, 2018
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.
October 15, 2017
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.
If you missed our Community Forum: A Home is More Than Four Walls, check out the recap on our podcast This Is Integral. Darilynn Cardona-Beiler, our Director of Adult Behavioral Health Services, Chris Laguna, our Practice Administrator for Housing and Homeless Services, and Anne Nagelkirk, our Director of Communications and Engagement share some of their favorite moments from the forum and talk about Integral Care’s work in homelessness and housing.
A home means access and connection to community, quality health care, and recovery – all of which help build health and well-being. Organizations across Travis County work to prevent homelessness as well as engage individuals experiencing homelessness, connecting them to housing so they can regain their health and independence. When people have a safe place to call home and access to support services in the community, they can thrive and meet their full potential.
Big thanks to our panelists Lisa Garcia, Vice President of Assisted Housing at the Housing Authority of the City of Austin Department of Assisted Housing, Alan Graham, Founder & Chief Executive Officer at Mobile Loaves & Fishes, Julian Huerta, Deputy Executive Director at Foundation Communities, and Darilynn Cardona-Beiler, Director of Adult Behavioral Health Systems at Integral Care.
November 13, 2018
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.
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.