H79SM085464

Cincinnati Restoration Initiative (CRI) - Greater Cincinnati Behavioral Health Services (GCB) will restore services impacted by the COVID-19 pandemic (C-19P) to address the needs of persons with serious mental illness (SMI) and those with co-occurring substance use disorders (COD). CRI aims to address gaps in services and infrastructure to minimize the impact of C-19P in Hamilton County, OH (HC). Behavioral health disorders are the most common health effect of the pandemic, and C-19P's sweeping impacts will have significant health implications in a state with the highest SMI prevalence in the U.S.

To address the current and emerging needs, GCB is seeking funds to address three gaps related to access, crisis services, and telehealth. C-19P has amplified the demand for treatment, with GCB admissions increasing by 40% while its workforce shrank by 12.4% during C-19P. The immediate impact of this was that admission teams could not provide same-day treatment access, and hospital and jail intakes declined by 31%. Psychiatric and care management services each fell by 26%, and average care manager (CM) caseloads increased from 34 clients to 44. As a result, 81% of clients experienced a service decrease, leading to unmet needs. Staff stress and burnout were directly related to staff shortages and higher caseloads.

Access to crisis services was also an issue, as GCB relied on HC's crisis continuum to address psychiatric crises, but these services were limited during C-19P. GCB's crisis response fell to care managers who were already overwhelmed. The impacts of C-19P are only beginning to surface, with GCB seeing a 30% increase in psychiatric emergencies and a 92% increase in overdose deaths since C-19P, highlighting the need to build internal crisis capacity.

To provide some service, GCB adopted basic telehealth since its electronic health record (EHR) did not have a telehealth platform, resulting in a shift from face-to-face services (95%) to telehealth (77%). This shift, coupled with workforce reductions, led to a $3.9 million revenue reduction in the 12 months after C-19P. GCB aims to restore clinical services and bolster telehealth to minimize C-19P's impact on clients, staff, and GCB.

CRI will serve 1,000 clients over 2 years, with a goal of 500 clients per year. The project goals/objectives focus on intake capacity, care management access, crisis services, and telehealth. CRI aims to achieve four goals: 1) expand intake capacity to meet treatment demand through a rapid engagement to care team to manage hospital and jail admissions, 2) expand care management access to reduce average CM caseload through four new care management teams, 3) increase crisis services to reduce psychiatric emergencies through a crisis support team and two additional crisis beds, and 4) expand telehealth through a new EHR with a telehealth platform. Key interventions include cognitive-behavioral therapy, critical time intervention, integrated dual disorder treatment, and motivational interviewing.

CRI's population will include new clients with SMI or SMI+COD assigned to psychiatric and care management services. 40% of the population have psychotic disorders, 50% have a COD, 55% are Black, and 42% are White. 52% of the population are male, and the average age is 44. Additionally, 86% of the population are below 100% of the federal poverty level. GCB has the leadership and experience to restore and bolster services with support from the Substance Abuse and Mental Health Services Administration (SAMHSA).

Greater Cincinnati Behavioral Health Services

NOT APPLICABLE

93.958 - Block Grants for Community Mental Health Services

Division of Grants Management [HHS - SAMHSA]

Cincinnati, Ohio 452373838 United States

Single Zip Code

Community Mental Health Centers Grant Program (SM-21-014)