2018 report summary - monroe county, new york

Prepared by: Monroe County Office of Mental Health

Mental Health Services in Monroe County, NY

Monroe County Behavioral Health Community Database

2018 Mental Health Summary Report

v Catholic Family Center v Liberty Resourcesv Compeer of Rochester, Inc. v The Mental Health Associationv Delphi Rise v Rochester Psychiatric Center v DePaul Community Services v Rochester Rehabilitation Centerv East House Corporation v Rochester Regional Health System (GMHC, RMHC, Rochester General and v Hillside Children's Center Unity Hospital)v Housing Options Made Easy v University of Rochester Mental Health Center/Strong Memorial Hospitalv Ibero-American Action League v Villa of Hope

http://www2.monroecounty.gov/mh-statistics-reports-new.php

Additional Information: If you have questions about any of the data included in this report, would like to request access to the Monroe County Performance and Contract Management System or would like to request additional analyses, please contact Deb Hodgeman at [email protected]. This report is available online at the Monroe County website in the department "Mental Health" on the "Statistics and Reports" page at

Introduction

The 2018 Mental Health Summary Report provides an overview of Monroe County’s mental health service delivery system, with specific focus on services provided to consumers during 2018. The data included in this report provide general information about service utilization and the demographic characteristics of consumers receiving services. In previous years, the report included detail comparing data for providers in each mental health program type. The detail has not been included in this document but is available to Monroe County providers in the Monroe County Performance and Contract Management System.

The data included in this report come from the Monroe County Behavioral Health Community Database (BHCD). This database is maintained by Coordinated Care Services, Inc. (CCSI) on behalf of the Monroe County Office of Mental Health to support contract management and county-wide planning, evaluation, and performance management efforts. The database contains sociodemographic, program admission, and service utilization data for consumers receiving mental health services at programs that are certified or licensed by the New York State Office of Mental Health or are fully or partially funded by the Monroe County Office of Mental Health. Providers with programs included in the database are listed below:

Most providers submit client-level service utilization data to MCOMH on a quarterly basis. The data files are run through several error-checking routines, processed, and added to the BHCD. Data for two adult housing providers (Ibero and Delphi Rise) are pulled directly from the Monroe County OMH SPOA database. This report is based on data submitted for services delivered to clients during calendar year 2018.

2019 Monroe County Office of Mental Health 2 July 2019

Mental Health Services for 2018 in Monroe County, NY

Demographic Characteristics of Service RecipientsThe charts below summarize the demographic characteristics of the 2018 mental health service recipient population as a whole.

Community Overview

Trends in Number of People ServedThe 2018 data show a total of 41,636 individuals received mental health services at the provider agencies included in this report—an insignificant increase compared to 2017 figures. However, total individuals served in 2018 increased by 14% when compared to 2014. Children and youth receiving mental health services in 2018 (9,096) increased by 10% from 2017 while Adults receiving mental health services in 2018 (32,540) increased slightly from 2017. When compared to 2014, adults served increased by 8.9% while children and youth served increased by 37%

36,50238,494 39,844

40,267 41,636

29,871 31,409 32,248 32,014 32,540

6,631 7,085 7,596 8,253 9,096

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

2014 2015 2016 2017 2018

Mental Health Service Recipients (Unduplicated) Monroe County, NY: 2013 - 2018

Total Clients Adults Children & Youth



Outpatient Community Support: Other Community Support: Vocational v Clinic Treatment (2100) v Assertive Community Treatment v Transitional Employment (0380) v Day Treatment (0200) v C&Y Family Support v Partial Hospitalization (2200) v C&Y Skill Building Residential v PROS (6340 and 8340) v Community Support / Mobile Integration Teams v Elmwood Transitional Residence

v Drop-In Center v Family Care Emergency Services v East House Affinity Place v Residential Treatment Facility C&Y v CPEP (3130) v MHA Life Skills v SRO v Crisis Intervention (2680) v MHA Transitional Coaching and Training v Supported Housing v Crisis/Respite Beds (1600) v PATH at RMHC v Treatment/Congregate (Community Residence) v Crisis Outreach/Mobile Crisis (1680) v Treatment/Apartment v Extended Observation Beds (1920) Community Support: Case Management v Family Crisis Support Services v Compeer One-to-One v Home-Based Crisis Intervention (3040) v Health Home Care Management

v Home & Community Based Waiver (0230)Inpatient v Non-Medicaid Adult Care Managementv Inpatient (3010) v Non-Medicaid C&Y Care Coordination

The graph below shows the distribution of individuals served within the Monroe County public mental health system by program category. For example, of the 41,636 individuals receiving services in 2018, 81% received care in an outpatient setting. A table showing the grouping of specific OMH program codes into categories is displayed below the graph. Note that these categories are not mutually exclusive. That is, a client is counted in each program category in which services were received in 2018. Percentages for the Adult population (32,540 served) and the Children & Youth population (9,096 served) are also shown.

Service Usage by Category



The graph below shows a trended view of the distribution of individuals served within the Monroe County public mental health system by program category for the years 2014 through 2018 for the Total Mental Health Population. The percentages of clients using Emergency and Inpatient services have decreased in 2018 from 2014. The percentage of clients using Case Management services has decreased slightly from 2014 after showing an increase due to the implentation of Health Home Care Management for both Adults and Children and Youth during this 5 year time period. This trend may be due to clients receiving Health Home Care Management services from one of the many providers not submitting to ths data resource. There has been some fluctuation in Outpatient service usage but the 2018 level is almost the same as 2014. Some of the changes are due to program openings and closings in the Monroe County system of care or agency discontinuation of data submissions to the community database.

Trends in Mental Health Service Use

0%

15%

30%

45%

60%

75%

90%

Outpatient Emergency Inpatient Community Support:Other

Community Support:Case Mgmt

Community Support:Vocational

Residential

81.7%

28.1%

8.0%4.3%

11.6%

0.2%4.1%

81.4%

24.7%

6.5% 4.9%10.8%

0.1%3.7%

Trended Service Use 2014 to 2018 for Total Mental Health Population

2014 2015 2016 2017 2018



Trends in service use in 2014 to 2018 for the Adult Mental Health Population (>17 years old) show similar patterns to the total mental health population in all program categories when comparing percentage of clients using services in 2018 to 2014.

Trends in service use in 2014 to 2018 for the Children & Youth Mental Health Population (<18 years old) show some differences from the total mental health population when comparing percentage of clients using services in 2018 to 2014. Outpatient service use is at it's highest point in this 5 year period and percentages of children & youth using Emergency services or Inpatient have not shown the same rate of decrease as the total population. Case management usage does not show the same increase as adults due to reporting of C&Y Health Home care management being limited to just one community provider.

0%

20%

40%

60%

80%

100%




Residential

81.3%

27.1%

8.6% 4.6%12.5%

0.2% 4.6%

81.0%

23.9%

6.9% 5.7%12.1%

0.2% 4.3%

Trended Service Use 2014 to 2018 for Adult Mental Health Population (>17)

2014 2015 2016 2017 2018

0%

20%

40%

60%

80%

100%




Residential

80.6%

32.7%

5.5% 2.6% 7.5%0.0% 1.8%

82.8%

27.8%

5.1% 2.3% 6.0% 0.0% 1.5%

Trended Service Usage 2014 to 2018 for Children & Youth Mental Health Population (<18)

2014 2015 2016 2017 2018



This graph shows First Contacts for 2014 to 2018 as the percentage of clients entering the Monroe County public mental health system through program categories of Outpatient, ED/Crisis, Case Management and Community Support. Refer to the section on Service Usage by Category for the lists of specific programs in each category. In 2018, the percentage of clients accessing the system through Outpatient is at its highest for the five year period and percentage of clients accessing the system through ED/Crisis programs is at its lowest. This is a positive trend.

Entry to Public Mental Health System

Monroe County OMH often reviews analyses showing the program that a client uses to first access public mental health services. The graph below presents the total number of first contacts for each year for the years 2014 to 2018.

56%

40%

1.6% 1%

59%

35%

2.1% 1%

58%

34%

5.4%1%

62%

32%

1.4% 2%

65%

31%

1.0% 2%0%

10%

20%

30%

40%

50%

60%

70%

Outpatient ED/Crisis Case Management Community Support

Location of 1st Public Mental Health System Contact - All Clients

2014 AllN=8,236

2015 AllN=8,924

2016 AllN=9,310

2017 AllN=10,156

2018 AllN=10,467



The graphs below display the percentage of clients entering the public mental health system through Outpatient, ED/Crisis, Case Management and Community Support by Age Group (Adults or Children & Youth). The trends show some variation between age groups. When comparing 2018 to 2014, Children & Youth show a steady increase in percentage accessing the system through Outpatient for 2014 to 2018 with a pause in 2016 into 2017. For Adults, there was a decrease in 2016 which could be related to data quality issues from one of our Adult Outpatient service systems. Both populations show an overall decrease in first contacts in ED/Crisis services, but the Children & Youth population held at the same rate for years 2015 to 2017. Adults also show a significant change in Adults first accessing the system through Case Management through 2016 with a drop in 2017 and 2018 which could indicate the Health Home care management programs reporting to our database have reached capacity.

55%

40%

2.0% 1%

58%

36%

2.8% 1%

55%

34%

7.9%2%

61%

31%

1.6% 3%

63%

31%

1.2% 3%

0%

10%

20%

30%

40%

50%

60%

70%


Location of 1st Public Mental Health System Contact - Adults

2014 AdultN=5,592

2015 AdultN=5,490

2016 AdultN=6,140

2017 AdultN=6,623

2018 AdultN=6.698

58%

39%

0.7% 0%

62%

34%

1.2% 1%

64%

33%

0.5% 0%

64%

33%

1.1% 0%

68%

30%

0.7% 0%0%

10%

20%

30%

40%

50%

60%

70%

80%


Location of 1st Public Mental Health System Contact - Children and Youth

2014 CYN=2,644

2015 CYN=3,434

2016 CYN=3,170

2017 CYN=3,533

2018 CYN=3,769



The graph below shows the percentage of clients receiving services in each disability area by race-ethnicity.

The main source of data for this report is the Monroe County Behavioral Health Community Database (BHCD) which is limited to mental health services. Monroe County also funds services for substance use and developmental disabilities. The graph below uses aggregate data available through NYS OASAS data systems (licensed substance use programs) and NYS Department of Health Data Warehouse (Mediciad claims) to compare the percentage of clients receiving services in each disability area by age group. Note: The Children and Youth age group is deifined differently across disabilities: Mental Health is < 18, Substance Use is < 19, Developmental Disabilities is < 21.

Mental Health Compared to Substance Use and Developmental Disability Services

22%

3%

32%

78%

97%

68%

0%

20%

40%

60%

80%

100%

120%

Mental Health(N=41,636)

Substance Use(N=13,295)

Dev Disabilities(N=6,128)

People receiving behavioral health services during 2018 by age group

Children andYouth

Adults

52% 55%63%

24%32%

21%15% 12%

8%6%1% 3%

0%

10%

20%

30%

40%

50%

60%

70%

Mental Health Substance Use Dev Disabilities

People receiving behavioral health services during 2018 by race-ethnicity

White

Black

Hispanic

Other


2018 report summary - monroe county, new york

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