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An inside look at Maricopa County’s evolving mental health system

Undeniably, one of the biggest issues of the day is how to reform our nation’s health care system. It’s a colossal task and one that’s long overdue.

The same can be said for mental health care in Maricopa County.

Transforming the county’s decades-old system will require us to think differently – from simply providing care to those in need to instead helping these individuals on their recovery journeys. I say “us”
because achieving meaningful change in mental health care will depend on many people and organizations – from providers and community agencies to government leaders and policymakers.

Magellan Health Services of Arizona serves as a critical point of connection to the more than 80,000 individuals who face life challenges as a result of mental illness or substance abuse issues. In collaboration with the entire mental health community, we are evolving our process-oriented mental health system to a model focused on recipient outcomes.

Of course, such an overhaul will take time and careful planning, but we are making measurable progress. Consider the findings from a report released earlier this year by the National Alliance on Mental Illness, which assesses the state of public mental health services. In that report, Arizona’s mental health system received a “C” grade. That’s a long way from where we want to be, but Arizona was one of just 14 states recognized for improving its level of care. The state previously earned a grade of a “D.”

It’s interesting to note that only six states received a grade higher than ours.

Equally as meaningful is the data collected by the Substance Abuse and Mental Health Services Administration (SAMHSA). As part of its National Outcomes Measurement System, SAMHSA tracks recipient resiliency and sustaining recovery in areas such as employment status, homelessness and re-hospitalization. In each of these categories, Arizona – of which Maricopa County makes up two-thirds of the data collected – is faring better than the nation as a whole. Most remarkable in the SAMHSA report is that the percentage of adults treated for mental illness and then re-hospitalized after 180 days was only 1.3 in Arizona, compared to 21.2 percent nationally.

While these are encouraging signs, we are doing more to propel our mental health system to an even higher level.

We are focused on a community-driven model of care. Both industry professionals and recipients have long envisioned a mental health system that combines national resources and best practices of the regional behavioral health authority with the expertise of community mental health providers. That vision was realized earlier this year when Magellan successfully transitioned the community’s 25 direct care clinics and Urgent Psychiatric Center to local ownership. The result: those who need care now have a greater choice of providers, and ultimately, a voice in their recovery.

The support system has been stepped up. During the past several months, the mental health community has also stepped up its focus on creating peer and family networks as part of recipients’ treatment plans. It’s all part of a plan to integrate recipients into their communities with the help of family, friends and other support systems. Not surprisingly, participation in the peer networks has soared to 82 percent from 15 percent just one year ago.

We are measuring real-time results. Another cornerstone of a recovery- based mental health system is devising a way to measure both system and recipient progress. An outcomes focus shifts the emphasis from how well professionals and programs are doing to how well individuals are doing to achieve their established goals. In short, outcomes gleaned from our new dashboard are the compass that ensures the people we serve are living meaningful lives in the community.

Magellan and its partners are launching a dashboard for monitoring and reporting real-time results across the county’s mental health system.

The dashboard features 18 performance measures that are monitored by clinic and recipient every month.
These are just a few examples of the positive changes taking place in Maricopa County’s mental health system; other forward-looking initiatives also are in the works. Among them: programs focused on health, wellness and life expectancy; a suicide-prevention and intervention initiative led by Magellan in concert with a host of partners, including the provider network operations leadership, police chiefs, legislators and others; crisis planning and clinical case management.

Together, such programs will strengthen our mental health system. More importantly, they will help those with mental illness enjoy life as many of us already know it, with a rewarding job, meaningful relationships and a sense of purpose.

- Richard Clarke, Ph.D., is chief executive officer of Magellan Health Services of Arizona, the regional behavioral health authority that oversees mental health care in Maricopa County.

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