Treatment of Mental Health and Recovery Support Services - 2011 Winners
Butte County Connecting Circles of Care
Connecting Circles of Care (CCOC) is a consortia of public agencies, non-profit agencies, and cultural communities (African American, Native American, Hmong and Latino), which provide wraparound services in rural Northern California. Funding was initially provided by a 2005 SAMHSA system of care grant to Butte County Behavioral Health but outstanding outcomes and strong community support generated a three-prong sustainability strategy to ensure continuity: 1) obtaining Medicaid funding for mental health services; 2) using Mental Health Services Act Funding for ancillary support; and, 3) creating CCOC, Inc, a derivative entity dedicated to providing culture-based training outside of the service area and generating ongoing revenue for CCOC.
CCOC implementation of High Fidelity Wraparound is intended to establish a higher standard for cultural competence (termed culture-based wraparound). Culture-based wraparound requires that families be able to choose staff members who are culturally and linguistically matched as well as to select culture-based services (e.g. , Native American drumming group, Black Effective Parenting Group, ceremonies led by a Hmong shaman).
Findings in comparison to other SAMHSA system of care sites suggest that a culture-based wraparound program is not only responsive to personal preferences of racially and culturally diverse youth and their families, but may also contribute to greater reductions in problem behaviors coupled with higher caregiver satisfaction. Wraparound Fidelity Index results also suggest that it is possible to establish culture-based processes while maintaining fidelity to the wraparound model.
Additionally, independent program evaluations for cultural competence have found CCOC to be reaching its clinical and programmatic objectives. CCOC has documented its process and results in two published research articles.
Center for Cognition and Recovery
The Center for Cognition and Recovery (CCR), a nonprofit LLC of the Jewish Family Service Association of Cleveland (JFSA) was formed by PLAN of NE Ohio (PLAN) and JFSA to disseminate Cognitive Enhancement Therapy Cleveland â„¢ Program (CET) to local, regional and national agencies. The CCR provides on-site and video conference instruction and supervision for CET training and fidelity-to-model training.
Challenged by the families of PLAN clients to find a cognitive treatment for their loved ones stuck in their recovery from chronic mental illnesses, PLAN started providing CET in 2000. After seeing the extraordinary results from CET, PLAN and then the CCR began disseminating CET.
CET is an Evidence Based Practice form of cognitive remediation which helps people with schizophrenia and related mental illnesses improve their processing speed, cognition (attention, memory, and problem solving), social cognition (the ability to interact wisely with others) and increase vocational readiness. A curriculum-based treatment, CET is conducted over 48 once-a-week sessions.
Designed as a one-time intervention, research has found that CET improves processing speed, working memory, executive functioning, social cognition and has significant durability. CET graduates have improved vocational success and quality of life. Adherence is remarkable with an average 85% to 90% attendance rate and an 85% graduation rate reported in over 85 CET groups with more than 600 graduates. "I like being in CET because they treat me like I have a brain".
Community Counseling Centers of Chicago (C4)
Community Counseling Centers of Chicago (C4) is a behavioral health advocate and social service provider offering quality comprehensive, community-based services, designed to meet the needs of diverse populations. Established in 1972 as a grassroots response to the deinstitutionalization of individuals with mental illness, C4, then known as the Edgewater Uptown Community Mental Health Center, provided community-based mental health care for vulnerable individuals re-entering Chicago's Edgewater and Uptown neighborhoods after leaving psychiatric hospitals. Thirty-nine years later, C4 has grown to include six facilities and remains committed to providing innovative and compassionate services that reflect best practices in mental health care, substance use treatment, help for those healing from sexual violence, and support for struggling families.
Since 2005, C4 has been a committed participant in efforts by the Illinois Department of Human Services to develop and provide Evidence-Based Supported Employment (EBSE)/Individual Placement and Support Services (IPS) to individuals with psychiatric disabilities. C4 is committed to the EBSE/IPS model, which is based on the overriding belief that all people with a serious mental illness have the ability to work in the competitive job market when their own goals and job desires are combined with their personal strengths and motivations.
Positive employment outcomes that are consistent with the consumer's vocational goals and recovery are a priority at C4. To that end, the agency has engaged a total of 238 consumers in employment services. Of the total number of persons served, C4 has achieved 105 consumer job placements/hires, resulting in an overall placement rate of approximately 44%.
Community Health Resources, Inc. (860) 731-5522
Community Health Resources is a leading behavioral health provider throughout Central and Northeastern Connecticut. CHR offers a full range mental health and addiction treatment programs for adults, children, and families. Incorporated in 1965, the agency has grown to operate nearly 80 community-based programs and 32 locations serving over 10,000 individuals a year.
In 2009, Community Health Resources implemented an Assertive Community Treatment (ACT) team to provide recovery oriented services to individuals with complex and persistent psychiatric and substance abuse problems who would otherwise require institutional services. The interdisciplinary ACT team serves as the clinical home for each participant providing home based psychotherapy and medication management, as well as intensive case management around issues such as housing, education and employment, maintenance of benefits, and social or recreational involvement. CHR’s ACT team has consistently met ACT fidelity requirements at the highest levels as a result of its creation of multi-disciplinary professional teams to meet the diverse needs of each client, its provision of service doses that reach or exceed two hours of weekly face-to-face interactions and its in-home service emphasis.
Over the two years since ACT implementation, 85% of participants have been maintained in stable housing for at least 1 year. Fifteen of the seventy-two individuals admitted have already been successfully transitioned to a lower level of care. Of the clients in the program at least 6 months, 64% showed improvement in their functioning scores and 49% dropped 1 or more levels of care on the LOCUS scale. In addition, after one year in ACT, 63% have continued to show improvement in their functional assessment scores.
Star View Community Services
(310) 868-5379, ext. 166
Part of Stars Behavioral Health Group, Star View Community Services (SVCS) annually provides mental health care to over 3,000 children and families across Los Angeles County, including some of the most sociologically impacted communities (e.g. , poverty, crime) of California. The agency offers a continuum of evidentiary practices aimed at helping young people and their families achieve health and wellness despite strained life circumstances.
Foster children are one priority population. California’s foster children have prevalence rates of mental health problems ranging upwards of 85%, with consequences for placement stability and permanency. The Los Angeles’ Department of Mental Health selected The Incredible Years (IY), Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), and Family Functional Therapy (FFT) to provide foster youth with best practices in mental health and SVCS heeded the call. Each evidence-based practice (EBP) requires multiple nodes of implementation including staff training and certification, supervision protocols, and fidelity and outcomes monitoring. To support effective implementation, the team added an EBP Coordinator to track and monitor outcomes and an EBP Director to assure model fidelity, direct necessary changes in agency protocols and collaborate with stakeholders. Various forums fostered a community of learning, resulting in high staff retention and employee satisfaction. Greater continuity of care from motivated and persevering staff, with enhanced competencies, means greater treatment effectiveness. SVCS outpaces California EBP comparisons on a range of indicators. SVCS achieved low drop out rates (e.g. , 13% for IY); marked reductions in child symptoms (e.g. , 70% for TF-CBT as reported by caregivers and 78% per children); and, significant gains in overall functioning (e.g. , 41% FFT improvements from mothers and youth’s perspectives). Additionally, caregivers, youth, and agency partners all report high satisfaction (over 90%).
The Parent Training Institute
The Parent Training Institute (PTI) is a specialized program within the San Francisco Department of Public Health that oversees the implementation and evaluation of evidence-based parenting interventions. The parenting interventions are delivered by nonprofit and civil service providers throughout the city and are always free of charge to families. The intent of all PTI activities is to improve child mental health and child welfare outcomes for families in San Francisco, and this work is made possible through blended funding from four family-serving city agencies: the San Francisco Department of Public Health, the San Francisco Human Services Agency, First 5 San Francisco, and the Department of Children, Youth, and Their Families.
Since September 2009 the PTI has overseen the rollout of Triple P Parenting, a multi-level parenting intervention intended to increase parental confidence and competence. The success of the Triple P program has led to its expansion throughout San Francisco, and to date 47 Triple P groups (Levels 4 and 5) have been delivered in three languages to 443 parents, affecting 804 children.
The PTI’s Triple P outcomes are evaluated in three domains: child behavior problems, parenting practices, and parental stress. An analysis of variance (ANOVA) found pretest to posttest change to be statistically significant in all three domains. Additionally, an analysis of co-variance (ANCOVA) confirmed the slopes of change were equivalent across four ethnic groups, indicating that the Triple P program is equally effective for ethnically diverse parents. These results demonstrate that carefully and collaboratively implemented practices yield the outcomes that diverse families want: fewer disruptive child behaviors and a more effective, less stressful parenting experience.
Last updated: 09/19/2011