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 VIrtual Communitty Forum informatiojnIntegral Care and Disability Rights Texas are excited to present a virtual community forum – The Rights of People Living with Behavioral Health Needs in Texas. Join us as we explore the history and rights of people who live with behavioral health needs, including mental illness, substance use disorders and intellectual and developmental disabilities in Texas, the protection of client information, how the law has changed over time, what the current law is and how this can impact service delivery and access to care. Learn more and register today.

On Wednesday, September 29 at 12pm, join Integral Care and the Central Texas Chapter of the American Foundation for Suicide Prevention for a virtual community forum about youth suicide prevention. Between 2007 and 2018, the national suicide rate among adolescents and youth increased by almost 60% – but there is hope. Prevention is possible when we focus on building protective factors and resiliency and ensuring that families have the education, tools, and resources to take early, meaningful action. Learn more and register today.

The University of Texas at Austin’s Dell Medical School and LBJ School of Public Affairs have released a cost-saving analysis of The Inn, Integral Care’s 16-bed residential treatment program. The study found that The Inn saves taxpayers millions of dollars in public costs while improving outcomes for people experiencing a mental health crisis.

Mental Health Weekly talked to Integral Care about The Inn’s approach.

Suicide numbers for ages 10-24 have been on the rise since 2007.  Integral Care recently produced 4 new short videos addressing teen depression and suicide. One video is for teens, the other for a parent/teacher audience. Both are in English and Spanish. The videos dig into the warning signs and how to reach out for help.

 

According to a CDC report released in June, emergency department visits for suspected suicide attempts rose among 12 to 25-year-olds between January of 2019 and May of 2021. Among girls 12 to 17, average weekly visits to the emergency department for suspected attempts from February 2021 to March 2021 was 50.6% higher than the same period a year prior. Among boys of the same age, the increase was 3.7%.  It’s important to note that these were attempts, and CDC data for actual suicides in 2020 has not yet been released. Until that data is released, it is unclear the effect of the pandemic and racial reckoning of the past year and a half.

 

We’d like to thank the Moody Foundation for the generous grant to create these videos. We hope you’ll share them with friends, colleagues, perhaps your child’s school or other organizations.

 

Our school-based therapist team has 10 easy tips for parents to help support a child’s mental health this back to school season. Download their Top 10 List, print it and post it on the fridge.

2020 was a year like no other, one that highlighted the strength and resilience of our communities as we faced daunting challenges and loss. Looking back across the year for Integral Care, I am heartened by the commitment, compassion and creativity of our teams. Through our first digital only FY2020 Annual Report, I invite you to learn about our work to improve the lives of adults and children living with mental illness, substance use disorder and intellectual and developmental disabilities (IDD) in Travis County.

 

As the Local Mental Health and Intellectual and Developmental Disability Authority for Travis County, our services are part of the publicly funded response to any disaster or crisis. We collaborated with other agencies and organizations to support our whole community as the COVID-19 global pandemic hit our communities. As dedicated public servants, our employees continued to provide face-to-face services as well as rapidly transitioning many to telehealth and telephone to support the health and safety of clients and staff.

 

As we personally and professionally tackled the pandemic, our nation faced a renewed call for racial justice and equity after the murder of George Floyd. In response, our Board of Trustees appointed a Board/Staff Ad Hoc Committee on Racial Equity and our staff initiated a town hall and other events to explore how our organization can learn about our own institutional racism and address structural inequities. Our board and staff together are exploring these issues with compassion for each other and a commitment to change.

 

Integral Care is committed to the health and well-being of our community every day – in good times and bad. If this year has taught us one thing, it’s that we are stronger together.

 

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Integral Care, the Local Mental Health and Intellectual and Developmental Disability Authority for Travis County, recently launched a new Assisted Outpatient Treatment (AOT) program, which will use practical, evidence-based interventions to build health and well-being for adults in Travis County who live with serious mental illness (SMI). The innovative AOT program is designed to improve adherence to mental health treatment plans, which reduces inpatient psychiatric stays and criminal justice involvement – and ultimately helps participants reach their full potential and thereby engage more fully in their communities. The program is a collaboration between Integral Care, Travis County Probate Court, Travis County Clerk’s Office and Dell Medical School’s Department of Population Health at the University of Texas at Austin. It will be funded by a U.S. Substance Abuse and Mental Health Services Administration grant award of $1 million per year, over the next 4 years. Together, these organizations will construct a framework of well-being through identification, referral, care and treatment of AOT clients who are weathering life’s storms.

 

“This grant brings together stakeholders across the community who are committed to building a healthier and stronger Travis County for all by ensuring that people living with serious mental illness are able to access and maintain the treatment they need,” said David Evans, CEO of Integral Care. “Together, we will provide intensive, specialized services that support the health, well-being and recovery of over 200 program participants.”

When experiencing a serious mental health condition, it can sometimes be difficult to maintain treatment that supports the ability to function in daily life and in the community. This can contribute to a range of challenges including alienation from family and friends, homelessness, and involvement with the criminal justice system. Studies show that by improving adherence to treatment services, AOT reduces arrests, hospitalization and incarceration of individuals living with serious mental illness by approximately 70%. These interventions save taxpayers 50% of the cost of care and most importantly improve the quality of life for individuals living with SMI. With this new grant funding, AOT will support individuals who have experienced multiple episodes of hospitalization, arrest, incarceration and homelessness due to the challenges of adhering to mental health treatment. Through this program, the Travis County Probate Court, presided over by Judge Guy Herman, which has primary jurisdiction over mental health hearings, will place individuals in court-supervised treatment while they continue to live in the community.

 

“The Travis County Probate Court is pleased to partner with Integral Care and the Dell Medical School to participate in the newly created Assisted Outpatient Treatment Program, which is designed to provide greater supervision for persons living with serious mental illness once they have left the hospital or jail and returned to the community, in the hopes of lowering the rates of recidivism in our hospitals and jails,” said Judge Guy Herman. “As the Presiding Judge of Travis County’s Probate Court, I am fully aware of the difficulty this population faces after being discharged from a hospital or jail, and I believe this program will fill a gap in service that could make a more stable life for our loved ones. The Probate Court has been attempting to establish an assisted outpatient treatment program for nearly ten years, and this grant will allow it to become a reality.“

 

Integral Care will monitor the individual’s treatment plan and help ensure their ongoing participation in the AOT program, facilitating their transition from inpatient hospitalization to community-based care through proactive relationship building, case management, therapy, medication, drug and alcohol treatment, and other services that support and maintain recovery. These tools will establish a foundation so clients have the stability to adhere to their treatment. Additionally, collaborative opportunities for clients will include the creation of Psychiatric Advanced Directives (PAD), facilitated by Dell Med. A PAD is a communication tool that promotes patient autonomy giving capacitated adults, living with serious mental illnesses, the legal authority to—in advance of a health care crisis – memorialize their preferences for care and to designate a proxy decision maker.

 

Respecting the autonomy of persons living with serious mental illness is the principle upon which this project is built,” said Virginia A. Brown, Ph.D., Assistant Professor Department of Population Health at Dell Med. “Collaborating with Integral Care to help improve the lives of persons living with SMI brings us one step closer to creating a more just and equitable community for all,” Brown said.

 

Progress happens when partners from different specialties come together to provide the building blocks of health for everyone in our community. Other collaborators include Austin State Hospital, Disabilities Rights Texas, Housing Authority of the City of Austin, NAMI Central Texas, and Travis County Sheriff’s Office.

Integral Care has been awarded the full SAMHSA Assisted Outpatient Treatment (AOT) grant ($1M per year over 4 years). The funding will be used to develop an AOT program to bridge the gap between inpatient and outpatient mental health services, improve treatment outcomes and reduce incidence of inpatient psychiatric and reduce criminal justice involvement. The Austin AOT program presents a practice and evidence-based intervention designed to promote treatment adherence, empower client engagement in managing their care, reduce inpatient bed stays and involvement with the criminal justice system. The population of focus for the program will be adult clients in Travis County who are persistently struggle with adherence to needed treatment for their mental illness and meet criteria for AOT under Texas state law.

 

The program will bring together Integral Care, Travis County Probate Court, Travis County Clerk’s Office and Dell Medical School at the University of Texas at Austin to establish a framework for identification, referral and the care and treatment of clients living with serious mental illness. Other community partners include NAMI Central Texas, Austin State Hospital and Travis County Sheriff’s Office. All client treatment plans will employ a recovery-oriented approach. Specifically, plans will include motivational interviewing strategies, psychiatric advanced directives, and collaborative, individually tailored plans of recovery.

 

Our sincere thanks to the large group of stakeholders who supported the AOT application, including the Travis County Attorney’s Office, Austin Lakes Hospital, Housing Authority of the City of Austin and Disability Rights Texas.

Integral Care received $275,046 from FEMA and SAMHSA to provide Crisis Counseling Program (CCP) supports and interventions beginning April 8, 2020. Integral Care is currently providing CCP supports and interventions to two primary populations: (1) the community at large in Travis County and (2) Travis County citizens who are staying as guests at a City-run isolation facility, housed at various hotels. Individuals who are staying at these facilities have been identified as “high risk” for contracting or spreading COVID-19.

 

Primary services include outreach, individual counseling, public education, individual education, trauma supports, referrals, and linkage.  The majority of these primary services are delivered via telephone and videoconferencing. Some services are delivered in-person as needed. Public education is provided via local media and social media outreach.

 

In addition, Integral Care is providing communications support for a statewide education campaign aimed to support the emotional health of Texans during the COVID-19 pandemic. The State of Texas launched a COVID-19 Mental Health Support Line (833-986-1919) to help people who are feeling overwhelmed by the pandemic, connecting them to a mental health professional who will help them with anxiety, depression, stress, grief and worry. The goal of the campaign is to help the community feel connected, offer hope during, and provide mental health support during this time of stress and uncertainty.

 

Integral Care received $275,046 from FEMA and SAMHSA to provide Crisis Counseling Program (CCP) supports and interventions beginning April 8, 2020. Integral Care is currently providing CCP supports and interventions to two primary populations: (1) the community at large in Travis County and (2) Travis County citizens who are staying as guests at a City-run isolation facility, housed at various hotels. Individuals who are staying at these facilities have been identified as “high risk” for contracting or spreading COVID-19.

 

Primary services include outreach, individual counseling, public education, individual education, trauma supports, referrals, and linkage.  The majority of these primary services are delivered via telephone and videoconferencing. Some services are delivered in-person as needed. Public education is provided via local media and social media outreach.

 

In addition, Integral Care is providing communications support for a statewide education campaign aimed to support the emotional health of Texans during the COVID-19 pandemic. The State of Texas launched a COVID-19 Mental Health Support Line (833-986-1919) to help people who are feeling overwhelmed by the pandemic, connecting them to a mental health professional who will help them with anxiety, depression, stress, grief and worry. The goal of the campaign is to help the community feel connected, offer hope during, and provide mental health support during this time of stress and uncertainty.

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.

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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.

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July 29, 2017

KAGS in Bryan/College Station recently did a story on suicide hotlines, featuring Integral Care’s 24/7 Crisis Helpline. Nicole Warren, Integral Care’s Crisis Helpline Program Manager, says: “Getting people connected with supports is so important.” If you need help, please call us 24/7 at 512-472-HELP (4357).

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June 8, 2017

Integral Care was recently featured in a Spectrum News story about the success of HOST, the Homelessness Outreach Street Team. HOST is a partnership of Integral Care, the Austin Police Department, Austin-Travis County Emergency Medical Services (EMS) and Downtown Austin Community Court. HOST was launched by the Austin Police Department with significant support from Mayor Pro-Tem Kathie Tovo and the Downtown Austin Alliance.  Integral Care brings the mental health and substance use disorder expertise to the team and is also pivotal in providing access to housing.

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August 1, 2017

KVUE featured a story about Integral Care’s soon-to-open Judge Guy Herman Center for Mental Health Crisis Care. “The Judge Guy Herman Center provides a different type of treatment for people experiencing a mental health crisis,” said Laura Slocum, an Integral Care Practice Administrator. “This really focuses on short-term stabilization with a goal of getting that person on a path to recovery as quickly as possible and having them return to the community as quickly as possible with support from Integral Care’s treatment teams.”

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July 17, 2017

KXAN highlighted the ribbon cutting ceremony of Integral Care’s soon-to-open Judge Guy Herman Center for Mental Health Crisis Care. The Herman Center provides 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. Austin Police Sargent Michael King said: “It’s going to be a valuable tool for the police department.” To learn more about the Herman Center, click here.

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April 28, 2017

KUT explored how housing can help individuals experiencing homelessness overcome addiction to alcohol and drugs. KUT asked Integral Care how we support our homeless community experiencing substance use disorder. “If someone’s living on the streets and struggling with a substance use disorder, it’s impossible for them to recover on the streets,” said Ellen Richards, Integral Care Chief Strategy Office. “We literally take people who are experiencing homelessness, move them straight into housing, regardless of whether they have an active mental illness or substance use disorder, and then we wrap rehabilitation supports around them so they can get on the path to recovery and a new life.”

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