Exemplary rural mental health services delivery.

Abstract

Southeast Mental Health Services, in rural Colorado, has successfully transitioned from a traditional model of maintenance and control to one focused on recovery and community integration. They moved from delivering day treatment, congregate living, assertive community treatment and nochoice therapy to providing individuals with choice of goals and the supports needed to achieve and maintain their goals. As a result, consumers are now living independently. Currently, 38 percent of those with serious and persistent mental illness are working, going to school or volunteering. The keys to this transition have been peer support networks, home healthcare aides, field case management and a crisis hostel with no threshold of symptoms for its use. Southeast Mental Health Services has achieved results and is a national example of the "transformation" called for in the President's New Freedom Commission on Mental Health report.

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Exemplary Rural Mental Health Services Delivery

Southeast Mental Health Services (SEMHS) is a model of rural mental health services delivery. SEMHS has a long history of providing services to rural Colorado residents, but since 2000, has transformed itself to become a visionary, recovery-based program. The services today embody the values of recovery and rehabilitation that are described in the 2003 President's New Freedom Commission on Mental Health's report. (1)

In 1995, the state of Colorado capitated the provision of mental health services for its Medicaid-eligible population. At that time, SEMHS became part of SyCare LLC, Inc., a group of four community mental health centers in southern and southeastern Colorado. SyCare joined ValueOptions, a Virginia-based managed behavioral health organization, to form SyCare-Options Colorado Health Networks, LLC, a 50/50 public/private partnership that currently holds the capitated contract with the state of Colorado. Moving to a capitated model enabled SEMHS to create additional services that were more relevant to its consumers and the community. This, coupled with managerial and executive shifts, helped to move the center to where they are today. In 1998, the new executive director, Bob Whaley, took over and provided the vision and leadership for many of the new and innovative programs that today mark SEMHS as a leading example of rural mental health service delivery.

SEMHS is a private, nonprofit corporation serving six Colorado counties. These counties are primarily rural and frontier and are sparsely populated. The counties cover 9,600 square miles with a total population of only 52,400 people. This represents nearly 10 percent of Colorado's total landmass, but only 1 percent of its total population. In addition to geographic challenges, there are economic challenges as well. The median family income for these counties is significantly lower than the median family income for the state as a whole.

SEMHS provides seven-day-a-week, 24-hour-a-day emergency services for all six counties, with a centralized phone system. Consumers living in outlying areas can call the center using a toll-free number. Transportation has always been a critical problem. Because of …