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Lucas County crisis aid plans makeover for mental health services

The Blade - 11/2/2020

Nov. 2--Crisis services in Lucas County are about to undergo a complete reworking to build an updated care model for those in need.

The Mental Health & Recovery Services Board of Lucas County is slated to issue Monday a request for proposals seeking vendors to implement a new system for emergency psychiatric and stabilization services.

"We're really trying to improve the treatment experience," said Jim Stengle, chairman of the board and co-chairman of its Community Psychiatric Emergency Services Subcommittee. "This is the largest RFP that we have ever done in any service venue within the mental health board of Lucas County."

The board spends about $4.5 million annually for crisis services through Rescue Mental Health & Addiction Services. The discussion began in February, 2019, with the creation of a subcommittee and later hiring consulting firm TBD Solutions to analyze current practices, research best practices, conduct stakeholder surveys and focus groups, and develop recommendations and an implementation plan. That plan was submitted in December.

"Where our committee process led us is that substantial improvements could be made in accessibility, client flow, and the manner in which we perform our everyday responsibilities," said Scott Sylak, the agency's executive director.

The process included input from a wide variety of stakeholders including providers, law enforcement and first responders, advocates, and individuals and families who have experience with Lucas County's current system.

"We spent a year listening, talking, interviewing, assessing with some very, very good professional facilitation that has now led us to the point where we are today," Mr. Stengle said.

The report compiled by TBD Solutions found the current system to be "subpar" in the areas of care coordination and outcomes-driven care. It rated the county as "acceptable" when it comes to its safety net and crisis continuum, and "good" for recovery-oriented care.

"What we've heard time and again ... is that [stakeholders] were not satisfied with what was happening," Mr. Sylak said. "Lives are being saved every day, but everybody had the opinion that we could do a better job."

Mr. Sylak said the board has implemented new programs over time, each aimed at improving care. But doing so piecemeal can create other problems and increase costs.

"They have a tendency to get fragmented over time," he said. "We felt it was time to bring it all back together under a single program model vs. a program for psychiatric urgent care, a program for stabilization, a program for mobile crisis. We knew that we wanted to add some components to our system ... and we wanted to consider how we do all that work in a manner that is fiscally responsible instead of just layering program on top of program with an existing provider."

One important piece is to establish a strong diversion program, whereby police can bring an individual in need of psychiatric care to a treatment facility instead of to jail.

"We are going to create a process where law enforcement, when engaging with individuals with psychiatric and substance-use disorders, will utilize a diversion option away from jail and into treatment to better support individuals who need the care of our system," Mr. Sylak said. "That process doesn't currently exist in our system."

Also included in the conversation is a need for preventive programs like the Wellness and Recovery Center and emotional support hotline to provide resources for people experiencing distress before they are in crisis.

Future discussions will include detailed planning for a seamless shift from the exiting system to the new model so care for active clients isn't disrupted, Mr. Sylak said.

Proposals are due by Jan. 18, and the board expects to garner interest from local and national vendors.

"The objective here is to have a very, very forward-thinking and literally the best arrangement we can have to provide mental health, behavioral health crisis services in Lucas County," Mr. Stengle said. "We want a system that becomes a model for others in Ohio and across the country."

First Published November 2, 2020, 8:30am

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