Rural health funding aims to address mental health care in Mississippi

Rural health funding intends to address. Rural health funding intends to address mental health care in Mississippi.

Key points

• She remarked Mississippi's two 988 call centers received 23, 646 calls last fiscal year, reflecting a 33.8% rise compared to the previous fiscal year.
• The model Mississippi Rural Health Program Advisory Council determined would best meet the state's needs is the Emergency Psychiatric Assessment and Treatment and Healing (EmPATH) model.
• The crisis residential units served 3, 600 individuals last fiscal year, with an average stay of 9 to 10 days.
• Patient with burn injuries to 96% of their body treated, discharged from Mississippi Burn, Hand and Reconstruction Center.
• The first round garnered more than 700 applications from more than 230 organizations.

Using the EmPATH model, authorities look to create soothing spaces near hospital emergency departments that will be staffed by mental health specialists.

Meanwhile, the establishment of specialized mental health crisis units in emergency rooms in Mississippi intends to fill a missing component in the state's continuum of care.

As part of the Rural Health Transformation Program, applications have been accepted to create open rooms within hospitals geared toward deescalating a situation where a person may be suffering from a mental health crisis.

Qualifying hospitals for the program are those serving rural areas in Mississippi.

For context, the model Mississippi Rural Health Program Advisory Council determined would best meet the state's needs is the Emergency Psychiatric Assessment and Treatment and Healing (EmPATH) model. Wendy Bailey, Executive Director of the Mississippi Department of Mental Health, remarked this model will fill a gap in current services.

This week, the advisory council closed the application process in preparation for awarding funding for the projects.

To ensure states are able to meet the mental health needs of their citizens, the Substance Abuse and Mental Health Services Administration (SAMHSA) established a set of crisis continuum benchmarks. There are four components within that continuum. It include providing someone to call, somewhere to go, someone to respond, and someone who can follow up after the crisis.

Mississippi is session a number of of those standards today, such as through the 988 Lifeline call system, the establishment of mobile crisis response teams in every region of the state, and the presence of 14 crisis residential units, Bailey explained.

She remarked Mississippi's two 988 call centers received 23, 646 calls last fiscal year, reflecting a 33.8% rise compared to the previous fiscal year. Of that number, 98% of the calls were answered by Mississippi-based personnel.

"I think we're really solid in Mississippi on our 'someone to call' part of the crisis continuum, " Bailey remarked.

For context, the crisis residential units served 3, 600 individuals last fiscal year, with an average stay of 9 to 10 days.

"What we did not have in that 'somewhere to go' part of a continuum is what nationally is referred to now as crisis stabilization, or emergency psychiatric, " Bailey explained. "We had not built out that part of the continuum."

For context, the EmPATH facilities are designed to provide short-term care of regarding 23 hours or less within a hospital setting. Once established, the facilities will provide law enforcement with a place to bring those suffering from a mental health crisis rather than move them to a jail or leave them in an emergency room.

"Neither one of those settings is truly optimized to provide timely trauma-informed psychiatric care, " Bailey observed. "Emergency departments do not have the adequately-trained staff for psychiatric emergencies." Families and individuals can additionally benefit from these units.

In practice, the advisory council discovered the EmPATH model recommended by SAMHSA during their research to improve care. To ensure the model was a good fit for Mississippi, Bailey remarked the advisory council toured already established EmPATH facilities in Tennessee, where they have a record of success. Under the model, regarding 75% of residents suffering a crisis are stabilized and returned home in less than 24 hours.

"And that's without the costly inpatient admission or an emergency department boarding, " Bailey remarked.

Notably, the aim is to provide a person in a mental health crisis with a space away from the hectic environments often experienced in hospital emergency departments.

"If you go into an emergency room there are all kinds of crisis and emergencies happening, " Bailey remarked. "You may have a gunshot victim, you may have someone that's been in a car accident. There are machines going off and there's just a lot happening since it is an emergency department."

EmPATH units are typically established close to an emergency department, but offer a quiet place with recliners instead of hospital beds, better lighting, and other amenities.

"When you come in, you receive a warm blanket. There's food, you have sandwiches, you have snacks. It's kind of dim lighting. It's particularly soothing, " Bailey described. These facilities will additionally be staffed by trained personnel.

"It is particularly calming. It is particularly therapeutic, " Bailey elaborated. "You are seen by a behavioral health specialist. It might be a psychiatrist, it might be a psychiatric nurse practitioner. You are seen, though, within 15 minutes."

Meanwhile, the combination of the environment of EmPATH units and the trained staff, including peer backing specialists, are designed to assist deescalate situations where a person is agitated, reducing the need for involuntary medication or physical restraints. While offering a secure observation area and have private evaluation rooms, the facilities are additionally required to be ligature resistant to protect those with suicidal thoughts.

In practice, the care provided in the units can support trained staff rule out whether a medical problem is an underlying cause of the crisis. It at times can lead a person to being denied service by a crisis residential unit.

"What we hope to see, and what we've seen in other states, is a decrease in the number of denials by the crisis residential services, " Bailey remarked.

Further, instead of that person being taken to a jail, EmPATH units offer law enforcement a single-point drop off location.

Some of the requirements for establishing an EmPATH unit is that they must be open 24 hours a day, 7 days a week to serve as a drop-off point for law enforcement. They require no appointment to be seen, provide a comprehensive psychiatric evaluation and a suicide and violent risk assessment, and additionally provide substance apply screening.

Trained staff within the facilities must be capable of initiating proper medication, and even adjust current dosages, provide detox services and withdrawal treatment. Nevertheless, these services are short term, lasting less than 24 hours.

"So if that individual is not able to return home and does need to be transferred to either an emergency department or a crisis residential unit, they'll be able to do that care coordination piece as well, " Bailey explained.

Hospitals that will participate in this funding opportunity will be tasked with creating an EmPATH unit through the renovation of space near the existing emergency departement, along with hiring staff to provide 24-hour access to psychiatric care.

Access to a psychiatrist could be offered through Telehealth, but there is a requirement for a number of trained staff to provide care in-person, such as a psychiatric nurse practitioner, peer backing specialist, and a registered nurse, to name a few.

Initially, Bailey hopes the program will fund three such units, with one each in the north, central and southern rural regions of the state.

Now that the application process is closed, she remarked the council would like to see the facilities operational within 12 months. Grant awards are projected to be issued in September.

"That will all depend on who applies, who is selected, and then, what renovations may possibly be needed and the hiring of staff, " Bailey explained regarding the opening of the facilities. "We want to get these services out there to Mississippians as quickly as possible." <!– AddToAny script (best before) –>.

Jeremy Pittari is a lifelong resident of the Gulf Coast. Born and raised in Slidell, La., he moved to South Mississippi in the early 90s. Jeremy earned an associate in arts from Pearl River Community College and went on to attend the University of Southern Mississippi, where he earned a bachelor's of arts in journalism. A week after Hurricane Katrina, he began an internship as a reporter with the community newspaper in Pearl River County. After graduation, he accepted a full-time position at that news outlet where he covered the recovery process post Katrina in Pearl River and Hancock Counties. For almost 17 years he wrote concerning local administration, education, law enforcement, crime, business and a variety of other topics. Email Jeremy: [email protected].

According to the center, the patient is the most severely burned patient to be treated in the facility's history.

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Taken together, the developments around rural health funding aims to address mental health care in Mississippi point to a situation that is still moving, and the coming days should bring more clarity.