Aroostook Mental Health Services, Inc. (AMHC) will build on its integrated behavioral health, substance use, and primary care services to better serve 935 individuals annually and about 4,700 individuals annually overall in rural Maine. The populations of focus, which include veterans, are individuals with serious mental illness (SMI); individuals with substance use disorders (SUD); children and adolescents with serious emotional disturbance (SED); and/or individuals with co-occurring disorders (COD).
Access to services, client retention, and staff hiring and retention are critical problems in this large rural area. The project has two goals: Goal 1: expand key services to address critical gaps and Goal 2: strengthen infrastructure and training to provide additional seamless, fully integrated services. Project objectives include expansion of low-barrier telephone access; targeted new staff hires (crisis call center; Peer Support Specialists; Registered Nurses, and youth prevention outreach); and new software to better monitor patient health data included self-reported data and expanded Human Resources functionality to track factors associated with staff turnover.
The catchment area (CA) is the 12,431-square mile region of Aroostook, Hancock, and Washington Counties in Maine. Unmet integrated BH needs are significant. All of Aroostook and portions of Washington and Hancock are Mental Health Health Professional Shortage Areas (HRSA, 2020). Participants in 2019 Community Health Needs Assessments (CHNA) in the region ranked mental health and substance use among their top three critical health concerns. COVID-19 has exacerbated stressors contributing to poor behavioral health. Chronic disease indicators are elevated in Aroostook and Washington including cardiovascular disease deaths (221.5 and 222.3 respectively per 100,000 versus 195.8 statewide) and diabetes incidence (13% and 12.8% respectively versus 10% statewide) (CHNA), 2019). The population is 153,107. About 94.4% of residents are White, 2.1% are Native American, 1.7% are Hispanic, 1% are Black, and 0.8% are Asian. A CA average of 14.6% live at or below 100% Federal Poverty Level (versus 10.9% statewide), and 13.7% under age 65 lack health insurance (versus 10.1% statewide). (U.S. Census, 2017, 2019).
AMHC is the largest provider of integrated BH services, including all SUD services, in the CA. SU treatment has been a cornerstone of AMHC’s integrated BH service delivery continuum since its inception. AMHC employs 325 staff, serves about 4,500 unduplicated individuals each year, and operates on an $18 million annual budget. AMHC has already met the majority of the CCBHC compliance criteria and will complete remaining compliance criteria within 4 months of notice of award. Maine is not a planning grant state.