Top Honoree: Community Achievement In Health Care
Adult & Child Center
Organizations of every kind struggle to break down work silos, those known enemies of efficiency and effectiveness. The stakes are even higher in health care delivery, where silos can be not just expensive, but deadly.
Adult & Child Center, a not-for-profit community mental health center founded in Indianapolis more than 60 years ago, has been on a mission for more than a decade to tear down silos and improve the health of its patients. By integrating the work of behavioral health and primary care providers, Adult & Child is improving the lives of teenagers and adults who struggle with mental and physical health disorders.
“There are no silos that separate our minds from our bodies,” said Allen Brown, CEO of Adult & Child, which has eight offices spread among Marion, Johnson and Bartholomew counties. “It makes sense to look at an individual’s total health and create an integrated plan.”
And that’s what Adult & Child has been doing since research emerged more than 10 years ago revealing that people with mental health conditions die, on average, about 25 years earlier than the general population.
“Integrated care has been on our agency’s executive dashboard for the last eight to 10 years,” Brown said. And it’s been in practice since 2010, when Adult & Child added primary care doctors to its main clinic at 8320 Madison Ave. More than 500 adults received integrated care in the first three years of the service. In 2013, through a partnership with The Jane Pauley Community Health Center, integrated service was extended to children as young as 13.
The results speak for themselves. In the first three years of the project, almost every patient left his or her first visit with one or more newly diagnosed physical conditions. After 12 months in the program, 30 percent of patients improved their blood pressure, 15 percent had lower LDL cholesterol counts, 7 percent had improved body mass index, and 6 percent had reduced tobacco use. After 36 months, the results were even better.
For its contribution to the physical well-being of the mentally ill in central Indiana, Adult & Child is the top honoree in the Community Achievement in Health Care category of Health Care Heroes.
Initial funding for the integrated care project came from the federal Substance Abuse and Mental Health Services Administration. “The funding through SAMHSA enabled us to develop an integrated health program, and to study its impact on participants’ health,” Brown said. “We were able to put people and processes in place to reduce these health disparities.”
A study of the results of the first three years of the program confirmed that people receiving integrated health services had higher-intensity needs than visitors to a general outpatient primary care clinic.
“Initial visits with a primary care provider typically lasted 45 minutes, which is an unusually long contact when compared to typical primary care settings,” Brown said.
The pilot project funded by SAMHSA was successful enough, Brown said, that the law now allows mental health centers to bill Medicaid for primary care services.
The value of the Madison Avenue clinic’s being staffed with both mental and physical health providers is the easy communication among the different types of providers, said Heather Todd, director of communications for Adult & Child. Todd said two more integrated care clinics are in the works.
April, a 34-year-old with schizoaffective disorder, clinical depression and PTSD, is among those who’ve received integrated health care services.
“The team nurse is working with me on my weight issues. The integrated care staff is great. They encourage me about losing weight … call to check on me and are very on top of things. … It has been really great to have the physical and mental health services in one facility. It helps me to take care of myself better,” April said.
Todd said word of the integrated service has spread, so that, in addition to people who simply walk in off the street, the clinic on Madison is getting referrals from primary care providers and emergency medicine facilities.
A recent enhancement to the service is Adult & Child’s Tech Enabled Behavioral Health Home, which serves clients with severe mental and physical health conditions. The service, believed to be the first of its kind in Indiana, offers enhanced access to treatment. Those in the program can connect to their providers remotely and instantly through a secure server.•