Services for Adults with Mental Illness
OBRA PASARR SERVICES
The PASARR program assesses a person's medical and mental health needs to determine the most appropriate placement setting and then to annually review those approved for nursing home placement to ensure that nursing home placement remains appropriate.
PASARR (Pre-Admission Screening/Annual Resident Review) is an assessment that screens consumers with diagnoses of mental illnesses and/or developmental disabilities whom are targeted for nursing home placement. The assessment consists of a nursing, psychosocial and psychiatric evaluation. When screening someone with a developmental disability additional assessments including psychological testing, occupational and speech therapy evaluations are required.
The preadmission screening is conducted in a variety of settings prior to nursing home placement and the annual assessment is completed yearly in the nursing home.
OBRA is a service providing mental health consultation with nursing home staff to ensure that Individuals approved for nursing home admission through the PASARR process are receiving appropriate mental health treatment. The staff are Mental Health professionals (LMSW). These staff provide nursing home monitoring and individual psychotherapy. NH monitoring can include recommendations concerning how to appropriately address the mental health needs of nursing home residents. Such recommendations can include referral to individual therapy or psychiatric services, as well as ideas for socialization, communication, behavioral modification, staff training, and linking with community resources and enhanced socialization including community outings. The OBRA staff provide individual therapy to enhance mental health recovery and assist nursing homes with discharges to less restrictive placements once medical needs subside.
Adult outpatient services provides a verity of individual and group therapies. The focus in adult out patient is on recovery and thus improving ones interpersonal and social relationships Treatments are individually designed to maximize psychological functioning, self-control, develop appropriate skills, normalize reality orientation, and emotion stabilization. Individual and group therapies are performed by mental health professionals ( LMSW,LPC,LLPC, ). Allegan CMH have therapist trained in several modalities such as (list out like MI/EMDR)
- Individual therapy
- Seeking Safety
- Testing Services
The psychiatric unit provides services to adults with a serve and persistent mental illness, adults and children with an intellectual disability and children with a severe emotional disturbance These services include psychiatric evaluation and medication review and health Services.
Psychiatric evaluation: A comprehensive evaluation, performed face-to-face by a psychiatrist or Nurse Pactitioner. The doctor or NP will ask questions to assess the presenting problem; the history of the present illness; previous psychiatric, physical, and medication history; relevant personal and family history; personal strengths and assets; and a mental status examination. This examination concludes with a written summary.
Medication review: This is a process where the doctor or Nurse Practitioner evaluating and monitoring medications your current medication. They will assess the medications effects, and the need for continuing or changing your medications. .
Health Services In psychiatric medication unit, Health Services are typically provided by an RN and include an initial review of the consumer's health-related needs. Additional services provided by the RNs include:
- Injection Clinic –nurses give injections of Haldol and Prolixin as are prescribed by agency physicians.
- Clozaril Clinic –nurses run a Clozaril clinic for clients who have been prescribed Clozaril. These clients are seen on a weekly basis for monitoring of their response to Clozaril.
- Lab Tests – Along with the physicians, the Community Support Services nurses monitor the results of lab tests ordered for Community Support Services clients.
Monitoring – When clients are seen for medication reviews, a nurse checks their vitals, does AIMS test when required, and educates the clients, family members and AFC providers about expected results and possible side effects of the prescribed medications.
Children and Family Services
Children and Family Services are always provided with consideration of the child's and their family's needs. The focus in the Children and Family Service Unit is on recovery and improving ones family structure and relationships. Services are individually designed to strengthen families and children. Services are provided by mental Health professionals (LMSW. LPC ect….). Services for families may be provided in the home as well as in the community. Services may include:
- Clinic based therapy-Parents and children meet at the clinic to talk about worries, problem behaviors, learn new coping skills. Parents further develop their parenting skills and learn how to understand and support their children.
- Home based services-Intensive services in which therapists go to the home and work with the child and family, who have multiple service needs and require access to an array of mental health services. Therapists support families in meeting their child's developmental needs, preserve families, reunite families who have been separated and provide treatment and supports to address risks that could increase the likelihood of a child being placed outside the home. They work on family issues, parenting, and problems kids have managing their emotions among other issues.
- Infant Mental Health-Therapists go to the home and help caregivers, infants, and little children ages 0-4 to build their relationships and form a secure bond, so children feel safe enough to learn and grow. The purpose is to preserve and reunite families.
- Support Coordination and Case management-Helps kids and families to connect to the community, and obtain necessary services. They check in to see "how kids are doing" at school, home and with friends.
- Psychiatric Services-Children may need to take medications to help with some problems. The Doctor (psychiatrist) meets with children and caregivers, and together they devise a plan that is right for the child.
- Wraparound-Wraparound is a highly individualized planning process that serves children who may be involved with multiple child serving systems, who are at risk of out of home placement, served through other mental health services with minimal improvement, and/or have numerous providers working with multiple children in a family without reaching goals. Child and Family teams, developed with the help of a Wraparound Facilitator, meet frequently, 4 times a month at first, to create a plan based on the strengths and goals of the family.
- Respite- This is a service for families, so caregivers can get a break (respite)-For children who qualify, a respite provider may meet weekly with a child, and take them out for a fun activity, or stay with the child, so parents can run errands or visit with others. It is a chance for children and parents to refresh and regroup. Respite camp is also in option.
- Medicaid Autism Benefit-Allegan residents, ages 18 months through 5 years old, with Medicaid or MI Child insurance, may qualify for special Applied Behavior Analysis (ABA) services. Children are screened, and if test positive, move on to participate in Autism testing. Depending on the results, they may be approved for the Autism Benefit. If so, further testing determines the amount of ABA services they qualify for, anywhere from 5 to 30 hours of therapy every week.
- Evidenced Based Practices-Allegan County provides several research and tested therapies that are shown to be effective in working with children and families.
- Trauma Focused Cognitive Behavior Therapy (TFCBT)-teaches parents about trauma and the effects of trauma, builds coping skills, teaches how to transform thoughts, and develops other methods to help children who have experienced trauma.
- Multidimensional Family Therapy (MDFT)-Intensive family therapy that treats youth who have an emotional disorder and substance use issues.
- Nurturing Parenting-Family and child program that improves parents' confidence in meeting challenging behaviors and builds the relationship between parent and child.
- Parent Management Training Oregon model (PMTO)-Empowers and trains parents to promote social skills and cooperation and prevent, reduce and reverse the development of moderate to severe conduct problems in children age 4 – 12.
- Wraparound- is an evidence based treatment, see description above.
Assertive Community Treatment (ACT) -
ACT is a service-delivery model that provides comprehensive, locally based treatment to people with serious and persistent mental illnesses who have been whose needs have not been met well by traditional approaches to service delivery. ACT is targeted to individuals who have the most serious and intractable symptoms of mental illness and experience the most severe difficulties with basic day-to-day functioning such as caring for basic physical needs, maintaining adequate and safe housing, and keeping themselves safe. Individual participating in ACT services receive services from a multidisciplinary team that includes mental heal professionals, RN, OT and psychiatrist. ACT team members are trained in the areas of psychiatry, social work, nursing, substance abuse, and vocational rehabilitation. The ACT team provides these necessary services 24 hours a day, seven days a week, 365 days a year. Treatment and services may include:
- individual supportive therapy
- mobile crisis intervention
- substance abuse treatment, including group therapy (for clients with a dual diagnosis of substance abuse and mental illness)
- behaviorally oriented skill teaching (supportive and cognitive-behavioral therapy), including structuring time and handling activities of daily living
- supported employment
- Peer Support Services
- support, education, and skill-teaching to family members
- collaboration with families and assistance to clients with children
direct support to help clients obtain legal and advocacy services, financial support, supported housing, money-management services, and transportation
Allegan CMH Crisis unit provides crisis services to the community 24 hrs. 7 days a week for 365 days a year. The ACCMHS crisis unit is staff by mental health professions that include LMSWs, and LLMSW. Staff within the crisis unit may provide or link and individual to the following services.
* Crisis counseling
The access unit is the front door to services at Allegan County Community Mental Health. Eligibility is based upon medical necessity as defined by Medical Manual.
ACCMHS professional will perform a comprehensive assessment to determine your current needs. Based on your assessed needs our mental health professionals will recommend appropriate services. If you are not eligibility for services at ACCMHS our staff will connect you to customer service unit or community resources to assist in meeting your needs.