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Panel Discusses the Role of the CBHC in Meeting Behavioral Health Needs

At a panel discussion on October 27, participants were enthusiastic about the potential of the state’s new Community Behavioral Health Center (CBHC) model in improving access to essential care for people and families and reducing the impact of urgent mental health needs on the healthcare and emergency response systems.

CHD hosted the panel discussion, “The Future of Community Behavioral Health,” at The Summit View Banquet and Meeting House in Holyoke with key community partners representing hospitals and health providers, law enforcement, school districts, the recovery community, and others.

CHD is one of 25 behavioral health and substance use providers in Massachusetts to receive the state’s newly developed CBHC designation. In January, our agency will open its CBHC at its new community-based location in Chicopee, where the program will provide a behavioral health clinic, mobile crisis services, and crisis stabilization for youth and adults in person and via telehealth.

The CBHC will serve Chicopee, Holyoke, Ludlow, South Hadley, Belchertown, Granby, Monson, Palmer, Southampton, and Ware—as well as individuals from any region who are already receiving CHD services.

Christy O’Brien, CHD’s CBHC program director—and co-moderator of the panel discussion—explained that in the decades since the deinstitutionalization of state hospitals and efforts to move services to community-based care, “the question of how we do this community-based care well continues to be asked,” she said. “Massachusetts redesigned its Behavioral Health Roadmap to include the CBHC model” to strengthen the behavioral health system, particularly routine, urgent, and crisis services.

“Right now, there is a gap between these levels of services—folks that are in the generally undefined level of care, and the CBHC is designed to provide a more integrated intersecting of those various programs, which can help those along the full spectrum of acuity,” said O’Brien.

Because people often turn to the hospital emergency department during a behavioral health crisis, the CBHC will deliver 24/7 community-based mobile crisis intervention and stabilization as an alternative to emergency room visits. CHD’s CBHC will also provide same-day evaluation and referral to treatment, evening and weekend hours, and timely follow-up appointments.

Panel participants agreed that at present there are gaps in community mental support measures that will hopefully be addressed by the CBHC. The need for more access for treatment was mentioned by Holyoke Police Detective Brian Summers, who has been with the HPD for 20 years. He said his department has dealt with a sharp increase in mental health-related incidents. “The rise in mental health calls in the last five years has quadrupled,” he said. Unfortunately, many of those involved end up in the hospital emergency department.

Earl Miller, director of Community Responders for Equity, Safety, and Service for the Town of Amherst, said his department often works with the Amherst Police, who answer about 20,000 calls a year, and an astounding 10,000 of them are mental health-related. “These calls take ambulances and police off the streets, so we’re not able to do preventative work because we’re responding to these things that we’re ill-equipped and ill-resourced for,” he said. “And they take a huge cost on the lives of the folks responding, who are just trying to do their job but are put in unwinnable situations on a daily basis.” The CBHC, he pointed out, “has the opportunity to change a lot of people’s lives in substantial ways.”

Nicole Arnold, an RN at Baystate Medical Center, said she hopes the CBHC would decrease the need for inpatient mental health care, especially since her hospital’s specialty inpatient behavioral healthcare teams are sometimes overwhelmed. Ideally, she said, individuals served would connect with a provider before there’s a mental health emergency. “People who need help need to be met where they’re comfortable, and the hospital is not where they’re comfortable,” she said.

Dr. Joeli Hettler is chief of pediatric emergency medicine at Baystate Children’s Hospital. She asserted that the present youth mental health crisis has strained her department’s resources. “Last week, in my 17 rooms, I had 18 behavior patients,” she said. Hettler welcomes an initiative “that can keep kids out of the emergency department.”

Jalil Johnson, VP of medical services at CHD, said that unfortunately, “in the current system, there is a gap, where people have to be quite ill before we see them. What I’m looking forward to most about the CBHC is a continuum of care. We will be able to meet them in the community and take care of them there. They may need inpatient services, or crisis stabilization services, or they may need outpatient services, so to be able to stretch that continuum gives me a lot of hope.”

Panel Participants:

  • Co-moderator Christy O’Brien – CBHC Program Director
  • Co-moderator Lindsay Ciepiela – VP of Clinical Services, CHD
  • Nicole Arnold, BSN, RN – Nursing at Baystate Medical Center, and Holyoke Public Health Advisory Council Member
  • Matt Leone, LMHC – Area Crisis Specialist; CHD’s CBHC Assistant Program Director
  • Earl Miller– Director of Community Responders for Equity, Safety, and Service (CRESS), Town of Amherst, and former Director of Recovery Services, DMH
  • Brian Summers– Holyoke PD
  • Joeli Hettler– Chief, Pediatric Emergency Medicine, Baystate Children’s Hospital
  • Frank Raschilla– Peer Specialist, CHD ACCS
  • Erika Hensel– Harm Reduction Counselor at Tapestry Health