One of the hallmarks of a CCBHC is timely access to treatment. The average wait time, nationally, for psychiatric services is 48 days and can be far longer in areas facing a shortage of providers. Most CCBHCs are able to cut their wait time to 10 days, and half offer same-day appointments.

“It’s vitally important that when people are ready to reach out for help that we can connect them to treatment as quickly as possible,” said Kelli Liechty, MSW, LCSW, director of Oaklawn’s CCBHC program and a former therapist. “We want them to be able to get into services at the point they’re most open to receiving it.”

There’s a number of methods CCBHCs can employ to reduce wait times. They include changes in scheduling practices, reducing no-shows and cancellations, extended office hours and more targeted, time-limited interventions.

At Oaklawn, some changes have already started, such as therapy appointments available during evenings, while others are being put in place. The majority of changes will happen behind the scenes, but the impact to clients is significant, and it’s something Liechty believes in.

“For people who are struggling to reach out and make that one call, that may be as much as they can do,” Liechty said. “We want them to leave that conversation feeling hope.”

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• 96% of CCBHCs can provide first appointments within 10 days

• Half can provide same-day appointments

Source: National Council for Mental Wellbeing

Crisis response is a critical component of CCBHCs – and one that holds great promise for transforming how mental health and substance use emergencies are handled in the community.

The existing mental health system relies on law enforcement and hospitals, but CCBHCs take greater ownership of crisis calls – typically through a multi-faceted approach including a 24-hour phone line, a crisis response team and innovative partnerships with first responders.

“The more we can shift crisis response for mental health and substance use to the people who have expertise in those areas, the better outcomes we can achieve for everyone in our community,” said Luke Lefever, MSW, LCSW, LCAC, manager of Oaklawn’s mobile services. “Connecting folks to the right treatment at their first contact is far more effective in the long run, and decreases our reliance on police and emergency departments, as well as their associated costs.”

Oaklawn is now piloting a 24-7 crisis line available to anyone in the community to call and speak with a staff member who can assess and triage need. Oaklawn is also assembling a multidisciplinary team including prescribers, therapists, recovery coaches and others who can respond to mental health crises in the community. Eventually, call center staff will be able to dispatch that team when it’s determined appropriate. For now, Oaklawn is focused on building infrastructure – hiring staff, working with key community partners and establishing processes and policies – with plans to launch the team by early 2022.

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People with a serious mental illness are more likely sent to jail or prison than hospitals or treatment centers. They’re more likely to encounter police than a mental health professional.

Source: National Council for Mental Wellbeing

It can be challenging to strike the right balance of services to clients facing serious mental illness. They may require more support than traditional case management but may not need services as intensive as inpatient or residential. CCBHCs commit to providing a higher level of service in the community.

“We’re looking to bridge the gap between supervised or residential services and traditional outpatient care,” said Mat Peters, MSW, LCSW, team leader for Adult Intensive Case Management.

Peters is leading a team who will serve a smaller number of high-needs clients. Case managers will meet with each client at least three times per week, establish detailed recovery plans, provide medication management, work toward stable housing and identify services and supports in the community that can help clients achieve greater independence. Psychiatrists will be consulted weekly for each client, with emergency appointments available for those who may experience crises. Eventually they hope to have a therapist dedicated to the team, providing group and individual therapy.

The team will also work collaboratively with Oaklawn’s crisis response team, anticipating overlap between the highest-acuity clients and those who may experience mental health crises in the community.

Peters is excited about the impact the program can have on clients.

“These clients we’re targeting have always been the clients I have a lot of passion about working with. They tend to suffer from severe symptoms and at times can be difficult to engage,” he said. “But we’ve also seen that with access to more comprehensive, frequent services and increased coordination of care these same clients can make great strides in their recovery.”

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In a CCBHC case study in Missouri during a 1-year period,

• Hospitalizations dropped 83%

• Emergency department services decreased 75%

• The state saved $128 million through integrated care

Source: National Council for Mental Wellbeing