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Enhancing Mental Health Care Continuity

This task force focuses on improving care for individuals with severe mental illness across various systems, prioritizing discharge barriers in State Hospitals, with a detailed timeline up to the final report in 2010.

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Enhancing Mental Health Care Continuity

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  1. Continuity of Care Task Force February 5, 2010

  2. BACKGROUND • The Texas State Psychiatric Hospital system is nearing capacity • While total admissions and civil commitments have decreased, the number of forensic commitments has increased • Forensic commitments generally involve longer lengths of stay • The increased number of forensic commitments and longer term patients has overcome the impact of decreased admissions

  3. TASK FORCE GOALS • Examine the overall continuum of care for individuals with severe mental illness who move through multiple systems • Make and prioritize recommendations to improve efficiencies, access and quality • Examine barriers to discharge for individuals in State Hospitals with extended lengths of stay • Make and prioritize recommendations to resolve barriers to discharge

  4. TIMELINE • Four Task Force Meetings • February 5, 2010 • February 19, 2010 • March 26, 2010 • April 16, 2010 • Four Public Forums • March 3, 2010, Czech Heritage Hall, LaGrange, TX • Individual Interviews • Meetings with Key Professional Groups • Final Report—September 30, 2010

  5. SYSTEM MAPPING • State Hospital capacity issues are multi-factorial • How do individuals move through systems? • What are the similarities and differences of this movement across the state? • What are some potential points of intervention? • What additional data do we need?

  6. POINTS OF POTENTIAL INTERVENTION • Community Prevention • Law Enforcement • Jails • Courts • Re-Entry/Re-Integration

  7. LAW ENFORCEMENT • Community Based Alternatives to Arrest/Incarceration • Wide utilization of MCOT? • Specialized Law Enforcement Teams/Models • Implemented in most urban areas? • Rural alternatives? • Law Enforcement Training • Discretion about Charges • Data Needs?

  8. JAIL BASED STRATEGIES • Screening/Assessment • Jail Based Treatment • Formularies • Forced Medications • Utilization of 16.22/17.032 Release on Personal Bond • Data Needs?

  9. COURT BASED STRATEGIES • Identification of behavioral health issues • Court coordinators • Raising competency • Specialized dockets/courts/attorneys • Restoration • Outpatient restoration of competency • Not likely to regain • Data needs?

  10. RE-ENTRY/RE-INTEGRATION • Discharge Planning • Jails • Prisons • Hospitals • Appointments • Medications • Housing

  11. COMMUNITY PREVENTION • Expansion of community based (not just crisis) care • Target population • Guardianship • Integrated Behavioral Health • ACT/FACT/FICM • Data Needs?

  12. NEXT STEPS • System Mapping Follow Up • Examination of Extended Stay Population • Other Stakeholders? • Future Planning

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