DEPARTMENT: Human Services
DEPARTMENT HEAD: Melody Woosley
COUNCIL DISTRICTS IMPACTED: Citywide
SUBJECT: Mental Health Systems Gap Analysis Briefing
SUMMARY:
This item provides a briefing on a Mental Health Systems Gap Analysis conducted by LadderLogik on behalf of the City and the County.
BACKGROUND INFORMATION:
In January 2019, representatives from a Joint City/County Mental Health Workgroup hired a local consultant, Ladderlogik to analyze and create a gap analysis with a focus on community and organizational capacity across the mental health system.
In the area of community capacity the consultant was asked to review and assess progress on a number of existing studies and plans to identify existing gaps in the mental health system. Additionally, the analysis looked at the distinct type of services needed to appropriately serve the diverse range of mental health and substance use needs in our community; identified recommended next steps; and anticipated the impact of expanding capacity and improving coordination. In addition, the consultant was asked to review organizational capacity as it relates to stakeholder roles, resources, and priorities.
In June 2019, Ladderlogik completed the City of San Antonio and Bexar County Mental Health Systems Gap Analysis, which provides multiple recommendations to address gaps in services, capacity and system structure.
ISSUE:
Based on the results of the LadderLogik analysis, the Joint City/County Mental Health Workgroup prioritized identified gaps as a guide for the City of San Antonio and Bexar County in identifying and allocating mental health resources. Currently, the primary means of accessing behavioral health services in a crisis event is through traditional hospital emergency departments. These environments are not conducive to helping persons with serious mental illness (SMI), intellectual or developmental disabilities (IDD), substance use disorder (SUD), or autism spectrum disorder (ASD).
The primary recommendation of the Workgroup is to create a pre-crisis urgent care walk-in center solely focused on addressing mental illness and substance use challenges before they reach crisis level. This pre-crisis center will provide triage; immediate access to psychiatric services; and on site pharmacy services to prevent escalation of behavioral health episodes to an emergency level. The Center would be available to both youth and adults suffering from a range of behavioral health disorders and would focus on prevention and education, early intervention and diagnosis support, and in and out-patient treatment services.
The primary goals of the pre-crisis clinic are to:
• Prevent mental health crisis by providing earlier access to treatment
• Reduce engagement of first responders in mental health crises
• Prevent chronic hospitalization for mental illness
• Increase access to consistent and continuous psychiatric treatment
• Improve access to medication to prevent lapse in coverage
• Provide support to treatment through service navigation and transportation
• Provide access to support services for family members of individuals diagnosed with behavioral health disorders.
To this end, the Human Services Department proposed to continue coordinating with Bexar County Department of Behavioral Health with continued guidance from the Workgroup to develop a concept plan and identify funding for the project.
ALTERNATIVES:
Individuals suffering from mental health illness will continue to have limited access to psychiatric services and medication to prevent crisis situations, resulting in frequent visits to emergency rooms.
FISCAL IMPACT:
There is no anticipated impact to the general fund as a result of this briefing.
RECOMMENDATION:
Staff recommends the Community Health and Equity Committee support the Joint City/County Mental Health Workgroup recommendation to create a pre-crisis center for individuals suffering from mental illness and to coordinate with Bexar County to develop a concept plan and identify funding alternatives for the Center.