innovations in mental health care · • hdc arranged housing and services • adult daughter...
TRANSCRIPT
Innovations in Mental Health Care
Donna Zimmerman, Diane Holliday-Welsh and Sue Hamel Friday, Jan. 10
5 - 6 p.m. Northland Ballroom
Donna Zimmerman
Donna Zimmerman is the senior vice president of government and community relations for
HealthPartners, a nonprofit, consumer-governed health care organization in Bloomington,
Minnesota. HealthPartners provides health care coverage to 1.8 million members and health
care services for more than 1.2 million patients each year. She is responsible for public policy
and community affairs strategies across the organizations. Donna collaborates with community
partners to improve population health in children’s health, mental health, and health equity. She
works in all areas of government and health reform product and regulatory strategy. Donna also
represents HealthPartners with state and national trade association appointments and
committees. She was previously the director of government programs at HealthPartners, with
responsibility for Medicare and state public programs. Her background is in administration and
policy, with leadership and executive experience in public and nonprofit sectors.
Diane Holliday-Welsh
Diane Holliday-Welsh is the operations administrator for Essentia Health’s East market
behavioral health and emergency medicine services. In this role, Diane has administrative
responsibility for mental and behavioral health inpatient, consult liaison, partial hospital
programs, outpatient clinic and primary care-based services, as well as, responsibility for
Essentia’s six East market Emergency Departments.
In addition to the Minnesota Hospital Association Mental Health and Behavioral Health
Committee, Diane is active with several Minnesota and Wisconsin state and community-based
initiatives with the goal of improved access and for care models designed to improve the
health status for individuals with substance use, mental and behavioral health needs and
initiatives focusing on ED utilization — in general and ED utilization related to a mental or
behavioral health crisis.
Sue Hamel, RN, MS
Sue Hamel, RN, MS, vice president and chief nursing officer, St. Luke’s Duluth, MN, is a
founding member of The Clarity Project, a regional mental wellness initiative, and a member of
the MHA Mental and Behavioral Health Committee.
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MHA Winter Conference,
“Connecting Care and
Communities”January 14, 2020
Make It OK is a community
campaign to reduce stigma
by increasing understanding and
creating caring conversations
about mental illness.
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It’s OK…to have a mental illness, many of us do.
1 in 5 adults will experience a mental illness
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Website
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Community Partnerships
• Media
• Business and employee wellness
• Public Health
• Health Care
• Faith Communities
• Schools and Youth organizations
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Ambassadors
• Ambassador
– Build capacity
– Fuel grassroots momentum
• Outreach
– Displays and events
– Presentations
– Employer engagement
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BACK FOR SEASON 4!
The newest season of this award-winning podcast delivers
frank, moving, and, yes, funny conversations with
celebrities.
PETE HOLMES
Comedian WHITNEY CUMMINGS
ComedianANIL DASH
Entrepreneur
MARA WILSON
Actress
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Make It OK Expansion
Darker color represents greater degree of community activity
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Make It Ok Toolkit Expansion
=Toolkit downloads from 7/2019-10/20/2019
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Make It Ok Results: IMPACT Survey
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What people
think about
mental
illness
Knowledge
of Make It
OK
The
difference
it’s making
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Make It OK IMPACT Survey Results
The community supports Make It OK.
• 9 out of 10 people believe it is important to reduce
stigma.
We are making progress! Between 2017 and 2019:
• Awareness of Make It OK has increased.
• Stigma has decreased!
It’s important to continue Make It OK:
• 3 out of 4 people don’t think that the community is caring
towards people with mental illness
• The community is ready to take action to reduce stigma with Make It OK!
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Engagement Opportunities for Health
Care Organizations
• Consider role as community “anchor” with expertise and service in mental health
• Engage local media as partners
• Internal employee campaign and engagement
• Create local MakeItOK advisory group to support ongoing outreach and evaluation
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“We are taught as children about illness
like colds, broken bones, or surgeries, but
mental illness isn't discussed. Mental
illness should be discussed like
diabetes…it needs to be seen as a
'normal' illness.“
IMPACT Survey Respondent, 2018
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Sue Hamel, Vice President, Chief Nursing Officer, St. Luke’s Hospital
Diane Holliday-Welsh, Operations Administrator, Essentia Health
Patient story 1
• Homeless patient presented to ED struggling to manage his diabetes.
• Had felt "let down" in past by those who were supposed to help him- this was going to be the last chance.
• Now has independent housing, a job and working to rebuild relationships.
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Patient Story 2
• Adult child and elderly parents presented to ED late one winter night.
• Living in their car and
struggling to manage mental
health and other medical conditions.
• HDC arranged housing and services
• Adult daughter worked with the Homeless Case Management team and found an apartment, obtained employment and continued care with case manager.
• Parents were housed at a facility where their medical needs would be met.
MHA Mental and Behavioral Health Committee
MHA Board
Registry Advisory
Committee
Delirium Committee
Falls Committee
HAI Committee
Medication Safety
Committee
Perinatal Committee
Pressure Ulcer
Committee
Sepsis Committee
Surgical Committee
Pediatric Committee
Community of Patient
Partners
Mental & Behavioral Health
Committee
Quality & Patient Safety Committee
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Priority 1: Mental health access website:
enhance participation and act on trends in data
Priority 2: Continue momentum with
community partnerships (CCBHCs, Innovation grants, etc.)
Priority 3: Measure improvement through Potentially Avoidable Days study, including ED
201Work planMBH committee 2019 work plan
1 of 8 Certified Community Behavioral Health Clinics (CCBHC)
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Collaborative Opportunity
• The Human Development Center (HDC) in partnership with Emergency Departments at St. Luke’s Hospital and Essentia Health – St. Mary’s Medical Center.
• Discharge and follow up plan with adult patients in which community discharge is possible with supportive services.
Program Design Goals
• Reducing hospital admissions and ED length of stay.
• Reduce diversions to outlying hospitals.
• Improve coordination of care, including a discharge and follow-up plan.
• Improve access to community based support for individuals with mental illness and co-occurring disorders.
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Demographic and Referral Process
• Adult patient presenting to ED with mental or behavioral health crisis.
• Medical screening exam completed.
• Deemed safe for community based discharge with support.
• Patient voluntarily consents to engage with HDC ED Case Management.
• HDC representative comes to respective ED, meets patient and arrangement for next step(s) are made prior to leaving ED.
• HDC hours: Monday – Saturday, 8 am – 11 pm.
Outcomes to date….
• EDCM coordinator who oversees access to and follow through on recommended/needed services.
• Average duration of Case Management is 2 – 4 weeks or until “close the loop”.
• July 2018 – December 2019, 255 individuals referred that have engaged in services (91 - St. Luke’s, 164 - St. Mary's).
• 146 were not connected to mental health or chemical health services prior to ED visit and HDC contact.
• 109 were or had been connected to services.
• Decrease in ED utilization: 25 patients contacted HDC coordinator instead of returning to hospital.
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Most frequent resource needs:
• Addiction Services/Rule 25
• Case Management
• Adult Rehabilitative Mental Health Services
• Outpatient Therapy
• HDC Homeless Program Team – 40% self reported homelessness.
• Transportation, including Chicago, North Dakota, Mpls.,St. Cloud.
On the horizon…
• Expansion to hospital inpatients.
• Exploring integration/colocation in outpatient clinics.
• Expansion to families with children.
• Further develop collaboration for individuals diverted out of the Duluth area for treatment to facilitate a seamless return to community.
• Establish sustainability plan.
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Patient Story 3
• Patient presents to EDs frequently.
• Felt she could handle things by herself and did not want to work with any providers.
• Pattern of ED returns continued for 6 months, until she had a triggering event.
• Instead of falling back into past habit of going to ED, she called the Human Development Center asking for help.
Navigating with our patients and families…
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Questions, discussion…
Thank you.
Sue Hamel Diane Holliday-Welsh