Behavioral Health, A Local Update

West Central is Making Great Strides Close to Home...

If you live in the Upper Valley or Sullivan County regions of NH and VT, you’ve probably heard about West Central Behavioral Health. West Central is a local, non-profit, community mental health center for this region, and it has been an active and indispensable part of the lives of thousands of people and their families since 1977. With clinical offices in Claremont, Lebanon, and Newport, NH, West Central serves people of all ages, from 2 years old to over 92 years old, regardless of their ability to pay.

What is behavioral health? According to the Centers for Disease Control, behavioral health encompasses traditional mental health and substance use disorders, as well as overall psychological well-being. Behavioral health can be understood as the behaviors that affect physical and mental health, and good behavioral health results in a “state of mind characterized by emotional well-being, good behavioral adjustment, relative freedom from anxiety and disabling symptoms, and a capacity to establish constructive relationships and cope with the ordinary demands and stresses of life”. In short, behavioral health treatment helps improve and save lives every day.

To help people achieve this improved state of mind, West Central has taken steps to bring experts in mental health and substance use disorder treatment directly into our communities to help people who otherwise might never have access to quality care. It has assembled doctors, nurses, therapists, case managers, social workers, supported employment specialists, crisis care workers, health mentors, and a host of others with expertise in helping people overcome life’s many obstacles.

Back in September 2019, the West Central board of directors, headed by Pete Bleyler of Lebanon, NH, hired Roger Osmun, PhD, who came to the Upper Valley from Pennsylvania where he ran a somewhat larger behavioral health non-profit. Roger, a psychologist whose clinical practice focus has been on children, has brought a great deal of expertise and positive energy to West Central. Even before the COVID-19 pandemic hit, Roger was working diligently with clinical and administrative staff to ensure the Electronic Health Record (EHR) system was updated and integrated with other administrative functions. In a world where Medicaid is the primary means of insurance for over 85% of West Central’s clients, having a well-coordinated EHR system can mean the difference between getting insurance reimbursement for services or not. With clients who are among the most vulnerable and marginalized in the region, Roger knew he owed it to them to ensure their bills would be paid.

Since the pandemic struck in mid-March 2020, the world went sideways, but West Central maintained a steady grip on its mission and the need to care for thousands of clients around the region. And its employees pitched in too, with many of them using their own resources to stay in touch with their clients from remote work places at home when clinics were closed. The IT department moved quickly to ensure all clinical staff had remote access to the online Electronic Health Record system so clients could continue to be seen and treated with minimal interruptions. In the case of many West Central clients, medications are necessary, and collaborations with multiple clinical staff members must happen in real time to ensure treatment plans are followed. Above all, patient welfare, and staff & patient safety were the main concerns. Everyone masked up and kept safe distances, and the entire West Central team pulled together to ensure no patient was overlooked. Many clinicians and case workers remained on the front lines, working with clients directly, knowing their clients’ treatment could not be interrupted or life would get much worse than even a pandemic-related illness might bring. These dedicated essential workers made a difference, and continue to do so as the pandemic wears on.

Roger came on board with the the broad goals of expanding client services, supporting staff in their work, and ensuring West Central’s financial stability. Since his arrival, West Central has opened a new substance use program called Medication-Assisted Treatment (MAT) to help those addicted to opioids break the cycle of addiction through a highly personalized program that uses suboxone and therapy. The MAT program launched in mid-April in response to the opioid epidemic that has shown no signs of slowing during the Coronavirus pandemic. If anything, drug and alcohol use are on the rise as a result of the isolation, and financial and personal stresses the pandemic has forced upon us.

Also during this time, West Central started to expand its emergency crisis services with an eye toward incorporating mobile crisis services offerings on a 24/7/365 basis. This is a critical foray into what is often a law enforcement situation that does not require the use of law enforcement personnel. Having trained mental health crisis clinicians at the ready to visit the scene of a mental health or substance use crisis often resolves it without the person being taken into custody or sent to an emergency room. The overall savings to the community are considerable, freeing up law enforcement to handle other matters. More importantly, it often results in far better outcomes for the people in crisis to know a compassionate and trained mental health worker is there to help them cope and recover.

And if that’s not enough, West Central is soon to add an integrated care component to its offerings. Integrated care is primary care coupled with mental health care under one roof, so people who otherwise would not seek out (or have access to) primary medical care will be able to see a primary care doctor in a West Central clinic. Not only will this give West Central clients a chance to get their physical health checked and followed, it will also allow for close communication between therapist and primary care doctor to ensure the best overall outcomes possible for clients. After all, the mind/body connection is a strong one, and a holistic view of caring for mental health and substance misuse patients is important.

Finally, West Central has initiatives now under way to expand child and family services in Newport, NH, as well as to add a new, early childhood treatment component to its program of offerings region-wide. These two new initiatives are in direct response to the need to identify, treat, and prevent mental and behavioral health issues in children and adolescents before they become overwhelming problems as they age.

Faced with tight budgets and low NH Medicaid reimbursement rates as compared to other states, West Central has turned to private sources for funding such as foundations and individuals. Small, incremental gifts and grants have begun to add up, and larger grants from private foundations have enabled West Central to take on many of the above initiatives in a sustainable way. There is, of course, always more to do when it comes to treating people for mental health and substance use disorders, but West Central recognizes the need to stay focused on delivering essential services in the kind, caring, and professional manner for which it has become known. This past year, West Central extended close to $600,000 in charitable care to its neediest clients. With so much financial uncertainty due to job losses during the pandemic, private charitable contributions take on a heightened importance to help many people who, already living at the margins, would never otherwise have access to the behavioral healthcare they need to survive and thrive.

Collaboration with community organizations such as schools, police departments, social services non-profits, corrections facilities, emergency rooms, nursing homes, and a host of towns, local groups and businesses has been a defining trait of West Central over the years. West Central staff live and work in their communities, and they care to be involved. Helping their clients is often helping the very people they live with and see each day in and around town.

Oh, and did you know, even during the pandemic, two important programs, InShape and Supported Employment, have continued. InShape health mentors are still helping clients stay healthy by checking in on them and encouraging them to stay active and eat healthy meals via phone calls and online video calls. And West Central’s Supported Employment specialists have continued to assist their clients to find and stay in jobs to ensure they get the mental health benefits so important to getting up each day and having the structure and satisfaction work affords. In fact, as the unemployment rates in the region have skyrocketed, West Central Supported Employment statistics have remained steady, pointing to how well the program supports its clients. Keeping people healthy, active, and leading productive lives not only helps them but also benefits our communities in many fundamental ways. Think of it this way, it’s better to have someone getting up and going to work, or getting up and enjoying the day with exercise and healthy lifestyle habits than not. It frees them up to be happy and enjoy their lives, and it frees our communities from having to support people in ways that can be socially and financially burdensome.

This all comes back around full circle to the definition of behavioral health that started this conversation. West Central, living up to its mantra of “Nurturing Dreams…Transforming Lives…”, places a premium on using evidence-based treatments that deliver outcomes to improve peoples’ emotional well-being and cope with the ordinary demands and stresses of life. Yet, even when we’re living in these pandemic-related extraordinary times, West Central and its devoted staff continue to rise to the occasion to ensure their clients, more than 2,000 in total around the region, suffer less and live more fulfilling and positive lives.

The author, Dave Celone, serves as West Central Behavioral Health’s director of development and community relations. He remains astonished at the sheer amount of effort his West Central colleagues devote to helping vulnerable people in need of behavioral healthcare close to home and within the magical Upper Valley/Sullivan County region of New Hampshire and Vermont. To watch lives being saved, and the physical and emotional well-being of clients improve each day is a marvel. The West Central website is at www.wcbh.org where information about its many programs for children and families, adolescents, adults, and elders may be found.