The Mental Health Service Delivery System in Missouri

1
The Mental Health Service Delivery System in
Missouri

• Brooke Dawson, LCSW
• Mental Health Manager
• Department of Mental Health

2
Missouri State Statute

• The States Revised Statutes of Missouri 2004
  RSMo 630.020 states
• The Department shall seek to do the following for
  the citizens of this state
• (1) Reduce the incidence and prevalence of mental
  disorders, developmental disabilities and alcohol
  or drug abuse through primary, secondary and
  tertiary prevention

3
Missouri State Statute

• (2) Maintain and enhance intellectual,
  interpersonal and functional skills of
  individuals affected by mental disorders,
  developmental disabilities or alcohol or drug
  abuse by operating, funding and licensing modern
  treatment and habilitation programs provided in
  the least restrictive environment possible
• (3) Improve public understanding of and attitudes
  toward mental disorders, developmental
  disabilities and alcohol and drug abuse.

4
Vision

• Lives Beyond Limitations
• Missourians shall be free to live their lives and
  pursue their dreams beyond the limitations of
  mental illness, developmental disabilities, and
  alcohol and other drug abuse.

5
Mission

• Working side by side with individuals, families,
  agencies, and diverse communities, the Department
  of Mental Health establishes philosophy,
  policies, standards, and quality outcomes for
  prevention, education, habilitation,
  rehabilitation, and treatment for Missourians
  challenged by mental illness, substance
  abuse/addiction, and developmental disabilities.

6
VR Mission Statement

• Making a positive difference through education
  and serviceThe Department of Elementary and
  Secondary Education is a team of dedicated
  individuals working for the continuous
  improvement of education and services for all
  citizens. We believe that we can make a positive
  difference in the quality of life for all
  Missourians by providing exceptional service to
  students, educators, schools, and citizens.

7
DMH Values

• Full Community Membership All people are
  accepted and included in the educational,
  employment, housing and social opportunities and
  choices of their communities.
• Access All people can easily access coordinated
  and affordable services of their choice in their
  own communities.

8
DMH Values

• Individualized Services and Supports All people
  design their own services and supports to enhance
  their lives and achieve their personal visions.
• Cultural Diversity All people are valued for
  and receive services that reflect and respect
  their race, culture, and ethnicity.

9
DMH Values

• Dignity, Self-Worth and Individual Rights All
  people are treated with respect and dignity and
  their rights are ensured by person providing them
  with services and supports.
• Prevention and Early Intervention All people
  live their lives free of, or are less affected
  by, mental or physical disabilities as a result
  of our emphasis on prevention and early
  intervention.

10
DMH Values

• Excellence All people determine the excellence
  of their services and supports based on the
  outcomes they experience.
• Valued Workers All people who provide services
  and supports are out organizations most
  important resource.
• Competence All people receive services
  delivered by staff who are competent in dealing
  with culture, race, age, lifestyles, gender,
  sexual orientation, religious practice, and
  ethnicity.

11
Putting People First

• Putting people first means ensuring that the
  Missouri Division of Vocational Rehabilitation
  provides the highest quality of employment
  oriented services to Missourians with
  disabilities. All of our policies, procedures and
  practices will reflect our commitment to
  providing consumers with the highest quality of
  services available. This commitment will always
  reflect and support the Missouri Division of
  Rehabilitation's Mission.

12
DMH Structure

• Seven member Commission appointed by the Governor
• DMH has three operating divisions Division of
  Comprehensive Psychiatric Services (CPS),
  Division of Alcohol and Drug Abuse (ADA), and the
  Division of Mental Retardation and Developmental
  Disabilities (MRDD)

13
Comprehensive Psychiatric Services (CPS)

• There are four regional hospital systems
  comprised of eleven CPS inpatient facilities.

14
CPS

• For the provision of community based services,
  Missouris 114 counties and the City of St. Louis
  are subdivided into 25 mental health service
  areas, each with an Administrative Agent (AA).
  AAs are community mental health centers
  responsible for the assessment and provision of
  services to persons in their designated area and
  for providing follow-up services to persons
  released from State-operated inpatient services.

15
Mil Tax Boards

• Eleven (11) counties and the city of St. Louis
  have passed Mental Health Mil Taxes and have Mil
  Tax Boards.

16
CPS Services

• Community Psychiatric Rehabilitation (CPR)
• Targeted Case Management
• Outpatient Community-Based Services
• Day Treatment/Partial Hospitalization
• Residential Care/Community Placement

17
CPS Services

• Inpatient (Hospitalization)
• Respite
• Treatment Family Home Program
• Access Crisis Intervention

18
Early Psychiatric Treatment Models
19
Procovery

• The Procovery Website introduces this practice in
  this way.

Individuals diagnosed with serious physical and
mental illness and chronic pain, and those who
treat them, often measure success by how well
they "recover" or return to a prior state of
health. Procovery is an approach to illness based
on the understanding that sometimes healing has
little to do with health sometimes recovery in
the traditional sense is not an option and often
we need to rewrite the scripts of our lives and
reach forward to the largely unknown rather than
backward to the familiar.
20
Numbers Served

• The estimated prevalence of individuals with
  mental illness in Missouri is 253,620 adults.
• In FY 2004, the Division served more than 70,000
  individuals.

21
Clients Served

• CPS Program FY2004
• Inpatient Services 8,482
• Outpatient Services 8,840
• POS clients 53,167
• Community Psychiatric
• Rehabilitation 30,004
• Community Placement 5,962
• Unduplicated Client Total 70,399

22
Clients shared with DMH 18,535 No DMH
connection 11,465
23
CPS Budget

• Adults 287,474,527
• Children 54,543,690
• __________________________________________________
  _____________________________________________
• Total 342,018,217
• Average Cost Per Client 4,626

24
Outcomes

• The National Outcome Measures have been developed
  by the Substance Abuse and Mental Health Services
  Administration (SAMHSA).

25
Abstinence

• For ADA this means from Drug and Alcohol Use.
  For CPS the desired outcome
• Decreased Mental Illness Symptomatology.

26
Employment/Education

• This is the second NOM listed. The desired
  outcome
• Increased/Retained Employment or Return to/Stay
  in School.

27
Crime and Criminal Justice

• The Desired Outcome
• Decreased Criminal Justice Involvement

28
Stability in Housing

• The Desired Outcome
• Increased Stability in Housing

29
Access/Capacity

• The Desired Outcome
• Increased Access to Services
• (Service Capacity)

30
Retention

• The Desired Outcome
• Increased Retention in Treatment for Substance
  Abusers.

31
Social Connectedness

• The Desired Outcome
• Increased Social Supports/Social Connectedness
  for Consumers in the System

32
Perception of Care

• The Desired Outcome
• Consumers/Clients Report Their Perception of Care

33
Cost Effectiveness

• The Desired Outcome
• Cost Effective Services

34
Use of Evidence Based Practices

• The Desired Outcome
• States will use Evidence Based Practices and
  Track the Effectiveness of These Practices.

35
Find out more about DMH at www.dmh.mo.gov

• You may reach me at
• brooke.dawson_at_dmh.mo.gov or
• call me at 573-751-8122