North Suffolk Mental Health Association (NSMHA) proposes a two-year Rapid Access (RA) Expansion Project at its North Harbor Clinics in Chelsea and East Boston, MA to: 1) reduce the percentage of individuals seeking RA services who are not served due to patient volume exceeding staffing capacity; and 2) increase service access for school-aged youth with untreated behavioral health (BH) issues by expanding a school-based mobile RA program.
From July 2015 and December 2019, NSMHA served 3,336 patients through RA, an average of 741 per year. In total, 6,525 people sought RA services (an average of 1,450 per year), but nearly half left without being served. Of those, 41% were asked to come back due to volume exceeding available staff. Among Chelsea Middle and High School students, 28% and 38% reported feeling sad or hopeless for two weeks, while 20% and 13% seriously considered suicide.
For over 60 years, NSMHA, which received CCBHC certification in 2016, has provided comprehensive, integrated, community-based services to children and adults living with serious mental illness, addictions, and co-occurring disorders. Chelsea and East Boston are both majority Hispanic/Latino, have around 20% overall poverty, with nearly 60% of the population on public health insurance, and around 70% of the population speaking a language other than English.
Goal 1: Expand RA service hours and improve RA model to increase the percentage of same-day engagement among individuals actively seeking services. NSMHA will expand RA services by 18 hours a week and redesign workflow to expedite intake and improve engagement.
Objective 1: Serve 72% of those currently turned away due to volume exceeding staff capacity.
Objective 2: Decrease wait times between check-in and triage interview to less than 30 minutes.
Objective 3: Decrease wait times from intake date to initial appointment to seven days or less.
Objective 4: Contact 100% of missed first follow-up appointments and try to engage directly.
Goal 2: Expand school-based mobile RA to address untreated BH issues among middle and high school aged youth in the North Harbor communities. NSMHA proposes to enhance this model by adding a Bachelor-level School Navigator to provide support and conduct home visits to complete required paperwork, thereby expediting enrollment and increasing clinical time.
Objective 1: Reduce the time from intake to first appointment from 13 days to seven days or less.
Objective 2: Pilot the use of telehealth in Chelsea schools to increase engagement with at least 10 students by January 2021, having the Navigator serve as the touch point before and afterwards.
Objective 3: Expand the program to a second North Harbor school district by September 2021.
Through its CCBHC Expansion, NSMHA proposes to serve 200 additional RA individuals in Year 1 and 216 more in Year 2, raising the average annual number served to 949 and the overall percentage of individuals served to 65% of those seeking RA services annually. For its school-based RA initiative, NSMHA aims to conduct 100 student intakes in Year 1 and 200 intakes in Year 2. In total, NSMHA will serve at least 2,198 unduplicated individuals in the grant cycle.
