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HEALTH: Innovative South Country Health Alliance program fills gap in rural mental health care

Owatonna Peoples Press - 11/24/2017

South Country Health Alliance (SCHA) continues to produce positive outcomes two years after implementing its Healthy Pathways program, a unique program that helps prevent deterioration of an individual's mental health status through early intervention of services and assistance in accessing appropriate levels of mental health services.

Since the start of Healthy Pathways on July 1, 2015, SCHA has served 102 SCHA members in seven of its 11-county service area, including Brown, Goodhue, Kanabec, Morrison, Todd and Wadena counties, as well as Minnesota Prairie County Alliance, a human services collaborative between Dodge, Steele and Waseca counties.

Together with its partners in county public health and human services agencies, SCHA has identified gaps in mental health care in rural Minnesota communities where there is limited access to mental and chemical health services and long waiting periods to receive state-required assessments for Mental Health Targeted Case Management (MH-TCM) services.

"Members were going to their county offices in mental health crises but would have to wait sometimes as long as two months without any support before receiving their assessments," said Gretchen Petterson, SCHA Healthy Pathways program manager.

Petterson explained that waiting for help with no interim support or services to address mental health symptoms often leads to further problems, including job loss, placement of children into foster care, homelessness, interaction with law enforcement, utilization of inappropriate health care services and failure to follow through on medically-necessary procedures. This results in overutilization of multiple county agencies, creating mounting expenses in county assistance.

"We needed a solution that provided more immediate intervention at the time someone is willing to accept mental health assistance," said Petterson. "That is what the Healthy Pathways program was created to do."

Since implementing Healthy Pathways, county public health and human services agencies have been able to offer support more quickly to SCHA members, eliminating long waiting periods.

By decreasing the utilization of multiple county agencies, Healthy Pathways has the potential to save counties tens of thousands of dollars per year.

Counties have reported several positive outcomes, including fewer incarcerations among participating members, fewer calls to law enforcement, fewer visits to the emergency department, successful treatment for substance use, more appropriate use of health care services and displaced children returned to their homes.

Healthy Pathways also serves as another option for SCHA members who no longer meet the criteria for MH-TCM services but still require services necessary to manage and maintain their mental health symptoms. This "step-down" service has not previously been available, and members often relapse when left with no supports in place.

"The Healthy Pathways program meets people where they are at in their recovery and allows them to have support they need and are willing to accept," said Petterson. "Members then have an ongoing goal of improving and managing their mental health symptoms. It is apparent that the programmatic approach of Healthy Pathways is benefiting our members."

SCHA members are identified as candidates for the Healthy Pathways program when they visit their county public health or human services agencies needing immediate assistance with their mental health symptoms. County case managers and health care providers can also refer members to the Healthy Pathways programs when they see a mental health need.

Almost half of SCHA members who participate in the Healthy Pathways program are diagnosed with major depressive disorder. Other diagnoses include bipolar disorder, schizophrenia, schizoaffective disorder, anxiety, post-traumatic stress disorder, substance use disorder and obsessive-compulsive disorder.

The Healthy Pathways program is funded by SCHA, exemplifying the county-based purchasing (CBP) health plan model of creating unique programs to meet community needs.

"Healthy Pathways has helped accomplish the South Country Health Alliance mission," said Petterson. "We will continue to explore new programs in the future to resolve other identified gaps."

For more information about Healthy Pathways, call SCHA at 507-444-7770.