In October 2009, United Way of Mid Coast Maine convened a broad group of stakeholders concerned about challenges in the delivery of mental health services in the Mid Coast region.

The forum included: Service providers Consumers of mental health services Hospitals State agencies Local and regional governmental representatives Social service agencies Educators Law enforcement Community members Clergy NAMI-Maine

That meeting led to a comprehensive analysis of mental health services, focusing on: Assessment of currently available services in

the region. Identification of those services that are serving

needs in an excellent fashion. Identification of gaps in services, including

services not available or individuals who are left out of the system.

Development of strategies to address the findings.

The project addressed four areas: Law Enforcement, including police/sheriff,

Corrections, and the Judicial system. Youth and Education, involving children of pre-

school through high school ages and issues affecting students in the school environment.

Community and Outpatient, addressing services available through provider agencies and private providers.

Crisis and Inpatient, including frontline response, agency services, and inpatient behavioral health units.

One of the key developments was the sharing of information and networking among the participants in the system.

The year-long effort resulted in a $50,000 grant from the John T. Gorman Foundation to address four areas.

In December, 2010 this initiative was merged with a project getting underway in Knox County looking at similar challenges with mental health services.

Four Areas Funded by JTG:

1. Crisis Intervention Training (CIT): Week long training program conducted by NAMI Maine to provide frontline officers with tools and techniques to deescalate crisis situations in the community, facilitating safer resolutions for the individual in crisis, family and friends that are involved, and the responding officer(s).

We supported the training of 33 officers in December 2010 and March 2011.

John T. Gorman Foundation Grant2. 2-1-1 Maine Listings of Mental Health Services

In conjunction with the 2-1-1 Resource Coordinators, we ensured that all the mental health services listed in the 2-1-1 database were complete and up to date.

We developed a key word for school staff, that would focus database searches for services for school age youth by zip code regions.

A “Guide to Mental Health and Social Service Resources” was developed for the schools in Brunswick, Harpswell, and Sagadahoc and Lincoln Counties.

John T. Gorman Foundation Grant2. 2-1-1 Maine Listing of Mental Health Services

Youth-oriented posters were developed to point kids with mental health concerns or issues to call 2-1-1 to find services.

John T. Gorman Foundation Grant3. Peer Services in Lincoln/Knox Counties

In December 2010, we began holding meetings in Rockland with a broad coalition of service providers, consumers of mental health services, social service agencies, State agencies, hospitals, law enforcement, corrections and other interested parties.

At regular meetings over the next 10 months, information about existing agencies and services was shared with the group and ideas on improving services were discussed.

The team developed a pilot project to establish Peer Support Services in Knox/Lincoln Counties. This was funded by United Way of Mid Coast Maine with a contribution from Maine Mental Health Partners.

Peers in the Crisis System – Knox County

Mid Coast Mental Health developed a pilot focused on embedding a peer specialist with their Mobile Crisis team. A goal is to shift thinking from a 100% clinical approach and offer different methods to help individuals in crisis.

Under the pilot, they are presently:

Developing a screening tool for finding and recruiting peers

Conducting a needs assessment to determine the best fit and use for peers in the crisis system.

Investigating the development of a Peer Development Intern Program, which could serve as a model or resource statewide.

Other Venues for Peer Support The team would create a plan defining the

mechanisms to disseminate information to Emergency Departments, clinics, social service organizations, churches, etc.

Discussion and planning is underway to create a regularly scheduled peer specialist visit to the jail. In addition, an on-call approach has been discussed and could be implemented to deal with emergent issues.

John T. Gorman Foundation Grant4. Delivery of information, resources, and

mental health services in a non-traditional setting. There are people left out of mental health service

delivery system for many reasons: Lack of knowledge of services No, or limited, insurance coverage No transportation Negative experiences with the system

A program was developed to take services to those individuals in a setting that was familiar and comfortable to them.

A partnership was formed with Mid Coast Hunger Prevention Program (food pantry), Tedford Housing (homeless shelter), and Oasis Health Network (free clinic for physical and behavioral health).

MCHPP donated space in their facility; many of their clients also use services provided by Tedford and Oasis.

Under this grant and other grant funding, Sweetser provided a therapist and case manager for monthly visits to the site.

The sessions included intake assessments and case management services for the work that followed the intake.

DHHS provided an Intensive Case Manager to assist clients with State-provided services, including applications to MaineCare.

A key element of this part of the project was to reach people who were not availing themselves of available services, and that has been successful.

Community Awareness/Stigma Reduction in Knox County

The key element of this part of the project is to create a program of awareness to identify, engage, recruit, and support individuals who are dealing with mental health issues. Awareness is a key part of recovery, including involvement and engagement. A sub-group of this team has been formed to address this issue. They will connect with social service agencies and organizations that have conducted successful awareness/education campaigns.

The focus now is to continue the pilot project at Mid Coast Mental Health Center to develop Peer Support programs and practices.

A Sustainability Committee was formed: An active collaboration between Pen Bay Health, Mid-

Coast Mental Health and Penquis was formed to apply for grant and foundation monies.

At this point we have applied to Health Resources and Service Administration (HRSA) for a 3 year grant to fund 5 positions for peer specialists and to expand this program

We have applied to the Bingham Foundation for some bridge funding to continue our peer support position until we hear about the HRSA Grant

We are continuing to identify additional funding opportunities

This approach and lessons learned will be incorporated into our Knox County planning grant for a Federally Qualified Health Center- which will integrate general, mental and dental health practices

In the long-term, these initiatives must be aligned with and be supported by State goals to make Peer Support Services a more accepted and available care option. Reimbursement for service is key.