Texas Mental Health Transformation
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11/24/2014 2:49:01 AM

Transforming Mental Health Service Delivery in Texas

To advance the vision created by President Bush’s New Commission on Mental Health as “a future when everyone with a mental illness will recover, mental illnesses can be prevented or cured, mental illnesses are detected early, everyone with a mental illness at any stage of life has access to effective treatment and supports – essentials for living, working, learning, and participating fully in the community,” in 2005 the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $92.5 million to seven states, including Texas, as Mental Health Transformation State Incentive Grants. The Texas award was granted to the Governor’s Office, which assigned management and coordination responsibilities to the Texas Department of State Health Services (DSHS).

As part of the project, Texas developed and regularly updated a Comprehensive Mental Health Plan (CMHP). In FY 2009,: a new conceptualization of the project, including an updated version of the Texas CMHP goals and sub goals, and progress on all project activities was introduced.

Texas’ Transformation project concluded in December 2011 with the final meeting of the Texas Mental Health Transformation Working Group (TWG), an interagency work group consisting of representatives from a wide range of government offices, the Governor’s Office, consumers, and family members. Over the six years of the project, the TWG oversaw a number of recovery-focused practical, consumer-focused, and sustainable infrastructure innovations that increased effective mental health services across Texas. While federal funded ended in September 2011, many of the infrastructure changes will continue to operate through others means of support.

Core accomplishments of the Project include:

While the TWG is no longer active, there are still opportunities for involvement in policy changes, including the Council for Advising and Planning (CAP) for the Prevention and Treatment of Mental and Substance Use Disorders, which was created to assure that all Texans have safe and effective prevention, treatment, recovery and resilience support services for mental and substance use disorders.

For additional information about opportunities to participate in policy development, please visit the Department of State Health Services’ web page at http://www.dshs.state.tx.us/mhsa/groups-and-councils.

Featured Transformative Activities

Via Hope Training and Technical Assistance Center

Via Hope is a training and technical assistance resource for mental health consumers, their family members, youth consumers, and professionals funded by a combination of SAMHSA Block Grant funds and support from the Hogg Foundation for Mental Health. It provides mental health consumers and family members with information and education that assists with their recovery, and enables them to better navigate the public and private mental health care systems. Via Hope operates certified peer specialist and certified family partner training programs as well as a Youth Outreach program. In 2012, Via Hope, in conjunction with DSHS and the Center for Social Work Research at the University of Texas, will be operating the Recovery Institute. The center is operated by Mental Health America of Texas and NAMI Texas.

Supported Employment

Supported employment is a well-defined approach to helping people with mental illnesses find and keep competitive employment within their communities. There are current efforts in Texas led by the Department of State Health Services, in partnership with the Hogg Foundation for Mental Health, to improve supported employment programs across Texas.

Community Collaboratives

To be successful, transformative activities must occur at both the state and local levels. Policy, infrastructure, and program changes solely at the state level will not result in improved access or outcomes at the local level without community-level, consumer-focused, implementation. The MHT project funds community-based collaboratives, representing the diversity of Texas, to demonstrate transformative efforts within Texas’ regions and serve as partners in testing new programs and infrastructure developed by both state and local-level organizations. Visit the Community Collaboratives page for more information.

Veterans’ Programs

In December 2008, a TWG subgroup on veterans developed a report, Behavioral Health Services for Returning Veterans and Their Families (PDF), which identified behavioral health needs – and gaps in services – of veterans returning to Texas from Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF). This report was updated in February 2011: 2011 Update: Behavioral Health Services for Returning Veterans and Their Families (PDF).

The 81st Texas Legislature allocated funding to the Department of State Health Services to help bridge those gaps by implementing initiatives to expand training for veteran peer support, enhance mental health services, and improve access to information about services available to veterans, service members, and their families.

TexVet is managed by Texas A&M University and is a collaborative effort of federal, state, and local organizations that focuses on bringing military members and those that care about them a wealth of resources. TexVet serves as a forum for interagency collaboration and provides information directly to veterans and family members, including its web-based resource directory. TexVet is also home to a new peer provider network.

Integrated Care

Persons with mental illness die an average of 25 years younger than the rest of the population. To help improve this population’s longevity, the Mental Health Transformation (MHT) Project allocated resources to advance the integration of physical and mental health care at the local level, with an initial focus on the MHT Community Collaboratives. Within each participating Collaborative, the Local Mental Health Authority (LMHA) worked in partnership with Federally-Qualified Health Centers (FQHCs) and other organizations to develop and implement plans that accelerated the integration of care between health care providers.

Resources made available to local communities include funding assistance through the Department of State Health Services’ Primary Care Office and Mental Health Transformation project and an online health assessment tool.

In addition to the health assessment, the MHT Project is also providing resources to assist clinics and care sites in modifying workflow processes and coordinating care with other organizations within the community to advance treatment for frequently-occurring conditions such as diabetes, cardiovascular disease, smoking, alcoholism, substance abuse, obesity, and depression. Further details are available on our Health Assessment Information page.

Continuity of Care

As individuals move between systems of care, such as the state’s psychiatric hospitals, community-based services, and other environments, it is essential that key components of any health condition or current service plan be appropriately and securely communicated so that appropriate treatment may be delivered. Texas’ transformation effort focuses on several key activities including a Department of State Health Services Task Force on the Continuity of Care, the implementation of technology solutions to support the continuity of care between the criminal justice and public mental health delivery systems, and the development of behavioral health data standards to enhance continuity of care between and among local behavioral health care providers as part of the Clinical Management for Behavioral Health Services (CMBHS) Electronic Health Record (EHR) system.

Behavioral Health Clearinghouse

The Texas Mental Health Transformation project sponsored the development of a Behavioral Health Clearinghouse. The Clearinghouse is a resource designed to assist state agencies, behavioral health providers, consumers, family members and interested stakeholders in finding up-to-date, relevant information about prevention, treatment, advocacy, and evidence-based practices (EBPs). It is a clearinghouse that links the user to websites with searchable databases or comprehensive behavioral health resource lists rather than providing the specific practice or resource on the site. In addition to linking to resources, the Clearinghouse contains a mapping function, which allows users to search for best practices occurring throughout the state and allows practitioners to submit best practices they are using to be included on the map.

Suicide Prevention Training for Public High School Teachers

At-Risk for Texas High School Educators at no cost to the end user for up to 40,000 Texas public high school educators. Available through the Mental Health America of Texas website, www.mhatexas.org, this unique program provides an online educational experience that helps high school faculty and administrators identify common signs and symptoms of psychological distress and have the confidence to take appropriate action such as a referral to the school counselor. The one-hour At-Risk training uses a research-based approach and proven techniques for identifying and approaching distressed students in order to take appropriate action.

Self-Directed Care

Self-Directed Care (SDC) is a new way of providing mental health services in which adults with serious mental illnesses directly control the funds spent on their recovery. Texas Self-directed care participants create a person-centered recovery plan and a budget for the purchase of goods and services to achieve their life goals. SDC Advisors help them hire providers and make purchases that lead to wellness. The program is operated by the North Texas Behavioral Health Authority in its 7-county area and is fiscally managed by Value Options. For more information see the Self-Directed Care website.