Monday, April 28, 2008

What's to be done: A discussion at Common Pathways

Common Pathways is a Worcester-based group of folks that serves Worcester as the Community Health Network (CHN) of Worcester City, that is trying to establish benchmarks and a pathway to the creation of a Healthy  City in Worcester.  Last Thursday night, I participated in a discussion of the mental health needs of the City of Worcester, based on a set of indicators that have collected over the past few years.  It was interesting:  it is hard to find indicators of mental health status in the data currently collected within the Commonwealth, and the one's identified so far are mostly measures of service delivery (number of Emergency Mental Health visits, for example) rather than outcome (such as rates of "mentally healthy children" in the various neighborhoods of Worcester).  We don't even have data on the prevalence of different diagnoses within the city, which makes it hard to look at our ability to meet the need-  we don't know the need that we need to address.  The indicators selected seemed to reflect people and families in crisis;  in addition the EMH visits, we had hospitalizations for substance abuse, drugs of choice for those in substance abuse treatment and the needs expressed in the Latino mental health survey.  All seemed to represent the end of journey, the sort of care that is provided after prevention and early intervention has failed.
Nonetheless,  our group took notice of the many bright spots regarding mental health treatment in Worcester over the past few years:  the HOPE coalition's efforts to integrate youth services and mental health care,  the Together for Kids program that has helped daycare and preschool program implement strategies to manage out of control children without expulsion and the Latino Mental Health Project which has promoted dialogue on differing perceptions of mental health within our community and Communities of Care,  our own answer to the Wraparound World .  Our task, however, was to try to come up with an idea or project that could be championed through Common Pathways that would likely affect the indicators that had been selected.  We came up with 2 ideas:
1)  Sell mental health to the people:  There is a huge amount of stigma associated with mental health diagnoses and patients in general don't like to talk about it.  Our group felt that this led to deferral of treatment and ultimately poor treatment.  We should develop a citywide marketing campaign that makes it OK to talk about mental illness, so that families wouldn't "put off" seeking care.
2)  Help break down the silos:  Often, the right hand knoweth not what the left hand is doing;  that is true within agencies and between agencies.  We discussed a souped up "211" line and other options for getting the word out about what different agencies can make happen making services more available to more people.
We were supposed to come up with one big project for our working group, so we sort of merged them and figured that the powers would make it all work.  Might be a bit much.  Our recommendations went the full committee for consideration and will likely make it out to the website later this month.
Getting late, and I must sleep.

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