A New Approach to Mental Healthcare

by Bonnie Eissner

For too many people with mental illness, crisis medical care has become the norm—a trend that takes a great personal and financial toll. In 2013, hospitalizations for Nassau County residents who received Medicaid mental health services cost the agency more than $35 million. The fact that many patients are rehospitalized within 30 days of discharge calls into question the effectiveness of this crisis approach to mental healthcare.

To address this issue, New York State is now working with physicians and health clinics to provide health homes for Medicaid recipients who suffer from chronic mental and physical illness. The health home concept is to offer an integrated system of care in which a patient’s needs—from scheduling medical appointments to providing transportation to those appointments to setting up social services—are coordinated by a small interdisciplinary team or an individual care manager.

Central Nassau Guidance & Counseling Services, Inc., based in Hicksville, New York, is one agency that offers health home services. Last year, with funds from a New York State Innovation Fund grant, the agency established its Stability at Home pilot program to help Medicaid recipients with serious mental health conditions transition from hospitalization or haphazard community care into a more stable home health system of care.

Chrisann Newransky, Ph.D., an assistant professor at Adelphi’s School of Social Work, explained that a primary goal of this new approach is to facilitate the many healthcare responsibilities and tasks that seem routine to the rest of us. “If people stay connected to the system—they don’t drop out of the system—then they’re less likely in general to use emergency care, which we know is completely expensive and not all [that] effective,” she said.

After consulting with Adelphi’s Center for Nonprofit Leadership and its faculty director, Peter Chernack, Ph.D., Central Nassau Guidance & Counseling tapped Dr. Newransky, whose primary research interests are disease prevention and health disparities, to be the external evaluator of Stability at Home.

Dr. Newransky is advising on the best sources of data and approaches to data collection for evaluating the program’s effectiveness for the nearly 150 participants and their families. She is also conducting independent follow-up research with the participants and families.

“What’s unique about the [program] design is that different organizations are coming together,” she said, noting that the Long Island Crisis Center and Options for Community Living, Inc., are also involved in the project. This coming summer, Dr. Newransky plans to interview the leaders of the three organizations in order to document this model of interagency collaboration and to understand what worked well and what improvements can be made.