Innovative Treatment Programs Recognized at APA Institute

The Baltimore Capitation Project, sponsored by Baltimore Mental Health Systems Inc., also targets persons with serious mental illness. In fact, the first group of enrollees came from state hospitals, and most of them had been hospitalized more than six years.

Capitation, which is a single payment rate per enrollee, allows the staff flexibility in terms of services and even offers opportunities for incentives such as dinner in a restaurant. Caseloads are small—eight or nine people—and each enrollee is visited an average of 12 to 16 times a month.

State psychiatric hospitalization in Maryland costs at least $72,000 a year. The average expenditure for residential rehabilitation is $53,000 annually, while the capitation rate is $27,000.

Hmong, Lao, Cambodian, Vietnamese, Somali, and Spanish are languages heard in the streets of South Minneapolis and spoken by the staff of the Community-University Health Care Center. The center’s mental health division won a certificate for its multidisciplinary effort to offer culturally appropriate mental health services to refugees and other immigrants.

A mime was brought in to help staff become more comfortable communicating without words, when language problems proved difficult. That gesture was one of many ingenious efforts to bridge cultures. In addition to a comprehensive array of conventional services such as group therapy, medication and case management, and independent living skills, the program provides activities, such as meditation and ethnic dance, that reflect the various cultures of participants.

Staff of the Multnomah County Early Childhood Mental Health Program take their services to their young clients. The first impetus for the effort occurred in 1990 when a Head Start program director noticed that children in the program were not well served by existing mental health services. Instead of focusing on conventional outreach methods, the program places early childhood mental health clinicians and child psychiatrists in public community agencies, such as schools, Head Start programs, and day-care centers that serve young children. Staff found that the stigma associated with mental illness is alleviated when services are offered outside of mental health clinics and that family members are more likely to be involved in the child’s treatment if it is part of an educational or community setting. In a recent survey, nearly 100 percent of families indicated that they were satisfied with the program.

The winning programs were selected from among 75 applicants by the 2001 Psychiatric Services Achievement Awards Committee, chaired by Michael Silver, M.D., of Providence, R.I. APA is accepting applications for the 2002 awards. The deadline for receipt of those applications is January 14, 2002.