This month, MSPPS features ACMH, Inc. to highlight the importance of addressing mental health illnesses and understanding the connection between mental health, primary care, and DSRIP. (Click here to read it on our website)

One of the key MSPPS projects is Project 3ai, which focuses on the integration of mental health and substance abuse services with primary care services to promote access and ensure coordination.

Importance of behavioral health and primary care integration

According to National Institute of Mental Health statistics, an estimated 43.6 million adults 18 years of age or older experienced a mental health illness in 2014.*  And adults in the U.S living with mental illnesses are likely to die earlier than the general population.**

In a study published in the February 2015 issue of  JAMA Psychiatry, researchers reviewed about 200 studies and conducted an analysis on mortality among people with mental disorders.*** They found that a significant percentage of deaths among people with mental health illnesses were related to the occurrence of diabetes, cancer, asthma, and obesity.**** 

Further research supports this. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 68% of adults with mental illness have one or more chronic physical conditions and more than 1 in 5 adults with mental illness have a co-occurring substance use disorder.

ACMH's reducing hospitalization admissions for mental health patients

ACMH Inc., which began by offering housing, psychosocial rehabilitation and care coordination services to individuals leaving what was then Manhattan Psychiatric Hospital more than 40 years ago, understands the importance of addressing the total health needs of individuals with mental illness.

They have been successful in improving the health of their patients. Between July 2014 and May 2015, 70% of new admissions to their housing from an inpatient setting had zero inpatient readmissions.  

The results are outstanding - statistics for the last year indicate that of all individuals served, 96% had a serious mental illness and 58% of them also had at least one chronic medical condition, the highest incidence being cardiovascular, diabetes, and pulmonary disease. By the end of the program year, 90% of clients served had a primary healthcare provider and found themselves making significant strides in attaining their behavioral and physical health goals. *****

ACMH's integrated approach

"Everything you name, we do at Garden House, cook-outs, movie night. I'm trying to get

 to level one with my medications, and they are working with me on medication management. I like the programs at Garden House. We're trying to get Bingo," said one of the residents attending a meeting of ACMH's Client Advisory Committee to the Board of Directors held last October.

Garden House is one of ACMH's 10 housing programs in New York City that provide on-site daily living support and integrated care coordination. ACMH, working from a strengths-based person-centered approach to care, assists its clients to define their goals for wellness and recovery and then provides training in skills for daily living, health education, relapse prevention, and vocational readiness.

In addition to supportive housing, ACMH provides "warm-touch" care coordination in the community at large for adults with mental illness and other chronic health conditions as a downstream care management provider to Health Homes, as well as to non-Medicaid recipients through a contract with the NYC DOHMH.

Both ACMH's supportive housing case managers and Health Home care coordinators make referrals to ambulatory care and supportive services and assist their clients to track upcoming appointments and fill prescriptions. While ACMH  doesn't provide treatment  itself,  their staff assess ongoing needs, support medication adherence and self-management goals, and assure that the array of the client's providers are informed of their progress, regressions, needs and preferences. ACMH staff teams meet weekly with a consulting community psychiatrist to review medication regimens, treatment plans, and the symptoms and side-effects of treatment for behavioral health and medical conditions so that they can more effectively assist their clients and keep their treatment team informed.

"For adults with serious mental illness, there are many challenges to accessing primary care.  We see our role as case managers and care coordinators as advocating for those we serve.  Medicaid re-design and the Mount Sinai Performing Provider System, in particular, hold great promise for breaking down silos of care and providing us the opportunity to increase access, coordinate services, and enhance our own understanding of best practices across health disciplines,"  says Daniel Johansson, Executive Vice President and Chief Executive Officer at ACMH, Inc.

Being a part of the larger solution

Over the last decade, ACMH, Inc. has also been forward thinking about its partnerships, including its collaboration with the Mount Sinai Health Home and St. Luke's inpatient staff to expedite enrollment in care management and participate in discharge planning.  ACMH is a member of Coordinated Behavioral Care, a collaboration of 50 behavioral health organizations in New York City, and of multiple Health Homes and PPSs in order to provide better access to quality services and care coordination for the persons it serves.   

	ACMH's newest housing project on E. 144th Street in the Bronx Picture by ACMH, Inc.

Today, they also see their participation in DSRIP as an opportunity to present their

 value proposition as a critical player in achieving the triple aim of quality, population health and savings for those with serious mental illness.  

"The heart of health care reform is care coordination, being able to focus on what we do, whether as a CBO, MCO, or a hospital," says Dan. "Seeing patients who have multiple needs: social needs, housing needs, medical needs - it really requires a team approach."

For more information about behavioral health and primary care integration, please take a look at this infographic from SAMHSA here. To learn more about ACMH, please visit:  www.acmhnyc.org