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Treatment of Mental Illness and Recovery Support Services
Community Solutions Inc.
Community Solutions, Inc. (CSI) is an experienced provider of nationally recognized evidence-based models including Multisystemic Therapy (MST), Brief Strategic Family Therapy (BSFT) and Functional Family Therapy (FFT). Since beginning as Connecticut Halfway Houses in 1966, CSI has grown and diversified in response to the needs of our clients, referral sources and communities. CSI operates 46 programs in Connecticut, Florida, Georgia, New Jersey, Pennsylvania, Louisiana and Rhode Island. CSI is currently providing home-based services in Connecticut, Florida, Georgia, Louisiana and Pennsylvania and has recently been awarded two new teams in Maryland.
Community Solutions MST program serves delinquent youth in Georgia based on the need to develop timely, cost-effective alternatives to detention. The State of Georgia Juvenile Justice Department selected CSI and the MST model because MST addresses the known causes of delinquency for an individual within his or her ecological context. The key to any successful MST quality assurance effort is fidelity to the model. Fidelity within CSI's MST programs is monitored through the weekly supervision/consultation process, and the collection of therapist and supervisor adherence measures. There are also recommended program practices that ensure that the organization housing the MST program has policies and procedures that promote fidelity to the treatment model. The annual follow-up results show that well over 80% of the youths were living at home, staying in school, and avoiding further contact with law enforcement 12 months after treatment ended.
Hempfield Behavioral Health, Inc.
Between 1986 and 2000 Dauphin County, Pennsylvania saw a 99% increase in the number of juveniles referred to the juvenile justice system. Given this data it was no surprise that Dauphin County's Juvenile Court out-of-home placement rate for youth age 10-17 was twice the state average. In 2001, Hempfield Behavioral Health joined with community leaders and county administrators to administer a four-year grant to bring Multisystemic Therapy to the county as a treatment option for treating youth with antisocial tendencies. Over the next six years the program continued to grow and spread to seven additional counties in Central Pennsylvania. This growth has, in large part, been due to Hempfield's ongoing commitment to maintaining fidelity to the treatment model as well as the commitment to tracking outcomes and demonstrating effectiveness. Hempfield Behavioral Health tracks treatment outcomes from pre-treatment to post-treatment at 6, 12, and 18 months intervals. This data is reported on a quarterly basis to all funding agencies. Outcome data has consistently demonstrated successful implementation of the MST model and clear benefits to the community as evidenced by decreased need for out-of-home placements, decreased criminal behaviors, and improved family functioning.
Department of Health and Mental Hygiene, Mental Hygiene Administration
There was a widely recognized need in Maryland to improve access to supported employment for individuals with serious mental illness (SMI) who desired such services. The purpose of supported employment is to attain competitive employment. Barriers to employment, shared by consumers, family members and providers, are seen in fear of loss of SSA benefits, public assistance, housing subsidies and access to health insurance. Moreover, both consumers and providers lack knowledge and expertise regarding work incentives that encourage individuals to return to work and maintain needed benefits and access to health insurance.
In this context, the Maryland Mental Hygiene Administration (MHA) implemented the evidence-based practice of Supported Employment (SE). A skilled Consultant/Trainer was hired to provide ongoing training, technical assistance, and consultation to program leaders, clinicians, employment specialists, consumers and family members on the application and implementation of the SAMHSA SE toolkit. In addition, MHA contracted with the statewide consumer organization, On Our Own of Maryland, to provide training directly to consumers on benefits and access. After training and consultation were provided, programs were evaluated to determine the program's fidelity to the evidence-based practice. MHA designed an enhanced rate structure to reimburse services delivered in accordance with the evidence-based practice service approach. The SE Initiative in Maryland has enhanced the quality of SE services, consistently yielding competitive employment outcomes ranging from 60% to 70% for SE clients compared to 35% for non-SE programs. This initiative has integrated funding and administrative procedures between MHA and the state vocational rehabilitation agency.
NAMI (National Alliance on Mental Illness) Maine
The substantial growth in the numbers of people with psychiatric and/or co-occurring substance use conditions who become incarcerated in Maine is well documented. Maine's jails have become the largest and least equipped providers of mental health services. In 2000, NAMI Maine recognized the need to do something about the number of inmates with mental illness/co-occurring substance use disorders and selected the Crisis Intervention Team (CIT) as a successful model for preventing incarceration of people with mental illness. The CIT model has been used primarily to train Law Enforcement Officers and NAMI Maine applied the use of this model to train Correctional Officers. CIT was selected because, when the model is followed, it results in significant short- and long-term benefits to individuals with mental health/co-occurring substance use disorders and builds lasting working relationships between community service systems that are often disconnected and have difficulty working together - service providers, families, consumers, law enforcement, and corrections. These collaborative efforts create systemic and sustainable change in local behavior toward one of Maine's most vulnerable and stigmatized populations - people with mental illness who have criminal records. NAMI Maine has assured consistent data collection for each site as well as adherence to the CIT model. In December of 2005, the Public Health Research Institute completed its evaluation of NAMI Maine's jail-based CIT program (the first of its kind in the nation). The report documented that CIT changed both the jail's and the officers' behavior.
Substance Abuse & Mental Health Services Administration • 1 Choke Cherry Road • Rockville, MD 20857