Outreach & Engagement in CCBHC

Presenter: Zona Whitewater, CCBHC TA TEAM
Topic: Outreach and engagement in community behavioral health clinics (CCBHCs)
Mental Health Statistics:
- 21% of adults are experiencing a mental illness (over 50 million Americans).
- 55% receive no treatment (over 28 million individuals).
- 70% of those who drop out of treatment do so after their first or second visit.

Define O&E: Identifying and developing community partners.
Understand O&E techniques and impact: Understanding how outreach and engagement activities work and their effect.
Clarify expectations: Clearly defining what is expected in outreach and engagement.

Cost of care: 43.9% of adults with AMI and 51.8% with SMI couldn't afford care.
Lack of knowledge about services: 33.1% of adults with AMI and 36.8% with SMI didn't know where to go for services.
Belief in self-sufficiency/problem-solving: 30.5% of adults with AMI and 27.3% with SMI believed they could handle the problem without treatment.
Concerns about psychiatric hospitalization/medication: 23.4% of adults with SMI were concerned.

Outreach is providing services to populations who may not have access to those services, typically in a mobile rather than stationary fashion.
Meeting people in need at their locations (home, shelters, etc).

Internal: New intakes, between programs, up and down in levels of care.
External: Hospitals, Emergency Departments, Urgent Care, Primary Care, Homeless Shelters, Substance Use providers, Private providers, Judicial system, Communal living/meeting locations, Schools.
Child welfare services, Indian Health Services and other social and human services for Criminal & juvenile justice including law enforcement, courts, jails, prisons, and detention centers (drug, mental health, veterans, and other specialty courts.)

Engagement is a strengths-based process where individuals with mental health conditions form a healing connection with people supporting their recovery.
Taking place within the context of family, culture, and community.
Based on person-centered care and therapeutic alliance.

Outreach activities to include but not limited to disease prevention, promoting wellness, and activities above and beyond routine activities.

Traditional: Hand out informational materials, general information on services, participate in community events, facilitate internal staffings, attend community coalitions, and provide general information/referrals for health and social services.
Enhanced: Engage in discussion of services and needs, provide specific and appropriate referrals, organize events to reach target populations, facilitate staffings and conferences with community partners to best serve target populations, and provide information/referrals with warm hand-offs and follow ups.

Review policies and procedures: Assess and update current procedures.
Prepare elevator speech: A brief and persuasive introduction of outreach services to potential consumers.
Provider language understanding: Use understandable terminology and address possible language barriers
Educate others on mental health: Help others understand and provide proper services.
Incorporate evidence-based practices: (e.g. motivational interviewing, and case management) and have experience assessing needs.
Team-based approach.

Introduce self: Convey genuine care and concern.
Build rapport: Develop meaningful relationships.
Speak about services: Be realistic and avoid over-promising.
Avoid promising employment or housing
Identify other potential consumers: Introduce oneself and services to those who may also need help.

Community Outreach & Engagement (H0023): Face-to-face or group activities directed to identify potential consumers.
Intensive Outreach (H0023): Activities focused on establishing trust, explaining services, and reducing resistance.
Outreach needs to be flexible: adapting to the target population and community setting.

Dedicate staff: Designate specific staff to outreach and engagement roles (avoid caseloads).
Engage difficult-to-reach consumers: Target high-need populations.
Contact information: Include at least two contact methods for hard-to-find contacts.
Policies and procedures: Clearly define how outreach and engagement will proceed.

Externally focused: Actively work with hospitals, jails, and various institutions.
Internal focus: Address disruptions or issues with service intensity, engagement, and barriers.
Liaison role: Work with community partners.
"Most In Need" (MIN) list management: Actively work with the targeted population.

Constructive approaches: Client-directed, strengths-based, empowerment methods.
Monitoring approaches: Intensive effort to engage resistant clients and to gather information.
Restrictive approaches: Intervention as a last resort.

Priority and training: Make successful outreach and engagement a priority and train staff accordingly.
Support and engagement: Share information, support decision-making, and treat everyone with respect.
Strengths-based approach: Take a strengths-based approach, building on client needs
Goal-driven services: Shaping services around client life goals and interests.
Adaptability and risks: Be adaptable and willing to take risks to meet clients where they are.
Family and support systems: Include family and support systems in the recovery process.
Recognize community, culture, faith, and identity: Recognize and promote sensitivity towards community cultures, faiths, sexual orientation, identity, and backgrounds in the process.
Peer services and family involvement: Involve peer support services, family involvement, and education for providers.
Promote collaboration: Collaborate with a wide range of systems including law enforcement, healthcare and housing providers.