CCBHC-IA (SM-22-012) - Upper Manhattan Mental Health Center's (UMMHC) CCBHC enhancements will reduce stigma, expand access points for care by deepening our community relationships, streamline intakes, and implement new evidence-based practices (EVPs) such as dialectical behavioral therapy (DBT) for children, adolescents and adults experiencing serious mental illness (SMI), serious emotional disturbance (SED), substance use disorders (SUD), and co-occurring disorders (COD) in Upper Manhattan and the South Bronx, New York City. These densely populated urban neighborhoods are comprised predominantly of Hispanic (55%) and Black (28%) residents who experience significant health and socioeconomic inequalities. Poverty rates, exacerbated by the pandemic, range from 15.5% to 34% in Harlem to almost 40% in the South Bronx (compared to 16% citywide). Rising rents and shifting demographics due to gentrification exacerbate these disparities. Although UMMHC provides vital BH and SDOH services to nearly 4,000 New Yorkers, significant need persists. Most of our neighborhoods are designated as primary and mental health care Health Professional Shortage Areas. Based on NYC 2021 Provisional Overdose Data, Harlem and the Bronx had NYC's highest rates of unintentional overdose deaths in the first quarter of 2021. Psychiatric hospitalizations are as high as 1,901 per 100,000 people, more than double NYC's average of 676 per 100,000 people. Drug related deaths are also disproportionately high, with some areas of our catchment experiencing 24.9 deaths per 100,000 people compared to 9.4 per 100,000 Citywide. Recent data demonstrates that wait-times for BH care can be up to 6 weeks with other providers, and some programs only accept referrals directly from an inpatient psychiatric hospital. In fact, the largest outpatient BH provider in the community recently closed its wait list.
Goals for this project period include streamlining access to UMMHC CCBHC services by refining our centralized intake process, increasing telehealth "pod" sites embedded within community partner sites (12 new sites); enhancing specialized team-based care to better address BH disparities experienced by Black and Hispanic residents; implementing new EBPs, including DBT and Trauma-Focused CBT (within 6 months of award, 95% of staff will be trained); implementing more targeted recruitment and retention plans for culturally and linguistically responsive staff; increasing community capacity to identify and address MH/SUD needs (expand SBIRT to 5 community partners); improving transitions of care from ED and inpatient settings into the outpatient CCBHC; and helping to reduce racial disparities by expanding access to social needs through strategic community partnerships. We propose to serve 1,000 unduplicated individuals over the life of the project.