The Mental Health Center Of Greater Manchester Inc

THE MENTAL HEALTH CENTER OF GREATER MANCHESTER CCBHC IA - THE MENTAL HEALTH CENTER OF GREATER MANCHESTER’S (MHCGM) CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) WILL CONTINUE ITS PROCESS OF TRANSFORMING THE COMMUNITY BEHAVIORAL HEALTH SYSTEM FOR THE GREATER MANCHESTER AREA. WITH A POPULATION OF FOCUS (POF) OF INDIVIDUALS ACROSS THE LIFESPAN WITH OR AT RISK FOR MENTAL ILLNESS AND/OR SUBSTANCE USE DISORDER, INCLUDING SMI (INDIVIDUALS WITH SERIOUS MENTAL ILLNESS), SUD (INDIVIDUALS WITH SUBSTANCE USE DISORDERS), SED (CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISORDERS), AND COD (INDIVIDUALS WITH CO-OCCURRING MENTAL AND SUBSTANCE USE DISORDERS) RESIDING IN THE CITY OF MANCHESTER AND THE TOWNS OF CANDIA, AUBURN, LONDONDERRY, BEDFORD, GOFFSTOWN, HOOKSETT, AND NEW BOSTON NEW HAMPSHIRE (A POPULATION OF ABOUT 207K) THROUGH THIS FUNDING. THE INDIVIDUALS IN THIS POPULATION HAVE COMPLEX AND OVERLAPPING NEEDS THAT REQUIRE AN INTEGRATED APPROACH TO ADDRESS EFFECTIVELY. THE PROPOSED CCBHC IA PROGRAM WILL PROVIDE FOCUS ON 2 OF THE 9 CORE SERVICES OF CCBHCS; IMPROVED PRIMARY CARE SCREENING AND MONITORING OF KEY HEALTH INDICATORS, HEALTH RISKS, AND PEER SUPPORTS. THERE WILL BE AN ADDED FOCUS ON THE 15-CENSUS TRACT AREA IDENTIFIED IN THE GREATER MANCHESTER 2022 COMMUNITY NEEDS ASSESSMENT, WHERE LIFE EXPECTANCY IS LOWER, OPPORTUNITY ATLAS SCORES ARE DIRE, CRIME IS HIGHER, AND POVERTY IS WIDESPREAD. WE WILL ALSO HAVE ADDED FOCUS ON BLACK, HISPANIC ASIAN, AND THE LGBTQI+ COMMUNITY IN OUR POF. IMPLEMENTING THIS PROPOSAL, MHCGM'S CCBHC WILL ADDRESS THE NEEDS AND GAPS OF THE POF BY INCREASING PATIENT ENGAGEMENT AND CARE ACCESS, THUS IMPROVING POF OUTCOMES. ADDITIONALLY, THIS PROPOSAL IS EXPECTED TO CREATE A MORE EFFICIENT AND EFFECTIVE DELIVERY SYSTEM FOR INTEGRATED BEHAVIORAL HEALTH SERVICES BY STREAMLINING PROCESSES AND REDUCING DUPLICATION OF SERVICES WHILE ENSURING THAT PATIENTS RECEIVE COMPREHENSIVE, INTEGRATED CARE. TO DO THIS, THE MHCGM CCBHC IA GRANT FOCUSES ON INFRASTRUCTURE DEVELOPMENT, IMPROVED COMMUNICATION OF NEEDS AND INTEGRATION WITH THE POPULATION OF FOCUS, AND ENSURING IMPROVED ACCESS TO CCBHC SERVICES FOR THE POF.

THE MENTAL HEALTH CENTER OF GREATER MANCHESTER'S CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC PROPOSAL - THE MENTAL HEALTH CENTER OF GREATER MANCHESTER (MHCGM) THROUGH SAMHSA’S CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION GRANT (CCBHC) WILL INCREASE CAPACITY OF OUR PROGRAMS, INCREASE ACCESS TO CARE, INCREASE CLIENT SATISFACTION, AND INCREASE THE SUSTAINABILITY OF PROGRAMS AT MHCGM. MHCGM’S CCBHC PROPOSAL IS IMPLEMENTING A THREE PRONGED APPROACH TO ACHIEVING THESE GOALS AND BETTER SERVE NH RESIDENTS, SPECIFICALLY THE POPULATION LIVING IN MANCHESTER, CANDIA, AUBURN, GOFFSTOWN, NEW BOSTON, HOOKSETT, LONDONDERRY, AND BEDFORD. THE POPULATION OF MHCGM’S SERVICE AREA MAKES UP ABOUT 15% OF THE POPULATION OF THE STATE AND IS VERY UNIQUE DEMOGRAPHICALLY AND SOCIO-ECONOMICALLY. THERE ARE APPROXIMATELY 45,000 INDIVIDUALS IN THE SERVICE AREA WHO LIVE AT OR BELOW 200% OF THE POVERTY LEVEL. THIS POPULATION IS LARGER THAN ALL TOWNS OR CITIES IN NH BUT NASHUA AND AN EVEN LARGER POPULATION THAN TWO COUNTIES IN THE STATE. THE MAJORITY OF THE 207K PEOPLE WITHIN OUR SERVICE AREA LIVE IN NEIGHBORHOODS WHERE THE OPPORTUNITY ATLAS NUMBERS PROJECT GENERATIONAL POVERTY AND A LOWERED LIFE EXPECTANCY. MEANWHILE 56% OF THE CLIENTS WE WORK WITH COME FROM MEDICALLY UNDERSERVED AREAS OR ARE DESIGNATED A MEDICALLY UNDERSERVED POPULATION (MUA/P). NEW HAMPSHIRE RANKS LOW IN A NUMBER OF HEALTH CATEGORIES INCLUDING 17TH HIGHEST RATE OF SUICIDE IN THE NATION, TOP 5 FOR OPIOID DEATHS IN THE NATION, 38TH IN THE NATION FOR SUBSTANCE USE DISORDER DIAGNOSIS, 32ND IN THE NATION FOR PREVALENCE OF MENTAL ILLNESS, AND 50TH IN THE NATION FOR ADULTS WITH A MENTAL HEALTH ILLNESS WHOSE NEEDS ARE BEING UNMET. THROUGH THIS EFFORT MHCGM WILL ADDRESS AND IMPROVE THESE STATISTICS. THE FIRST PRONG OF THIS PROPOSAL IS REACHING MORE OF THE MUA/P WITHIN OUR SERVICE AREA. THIS IS WHY MUCH OF THE FUNDING USED IN THIS PROPOSAL IS GOING TO BE EARMARKED TO HELP SUPPORT THE PROGRAMS THAT PROVIDE COMMUNITY BASED INTENSIVE ENGAGEMENT AND CASE MANAGEMENT SERVICES THAT ARE BASED ON IMPROVING THE CLIENT’S SOCIAL DETERMINANTS THAT PUT THEM AT RISK. THROUGH OUR MOBILE CRISIS RESPONSE TEAM (MCRT), OUR INTEGRATED TRANSITION TEAMS (ITT), AND OUR PROJECT FOR ASSISTANCE TO TRANSITION FROM HOMELESSNESS (PATH) TEAM WE ENGAGE THIS AT RISK POPULATION IN THE COMMUNITY, PROVIDE SUPPORT, AND WARM HAND-OFFS TO SUPPORT AND CARE A CLIENT NEEDS. THE SECOND PRONG IS IMPROVING FUNCTIONING AND STAFF SATISFACTION THUS IMPROVING CLIENT SATISFACTION. THE CCBC PROCESS HAS BEEN SHOWN TO IMPROVE THESE AREAS AND LESSEN STAFF TURNOVER. THROUGH THE CERTIFICATION PROCESS AS AN AGENCY WE WILL IDENTIFY MORE GROWTH AREAS AND HOW TO BETTER SUPPORT OUR STAFF AND THE CLIENTS WE SERVE. ALSO THROUGH THE USE OF FOCUS GROUPS WE WILL GAIN A BETTER UNDERSTANDING OF THE NEEDS OF THE COMMUNITY. THE FINAL PRONG IS THE INTEGRATION OF INNOVATIVE THERAPEUTIC PRACTICES INTO OUR SERVICES. THE FIRST OF THESE WILL BE THE IMPLEMENTATION OF TRANSCRANIAL MAGNETIC STIMULATION (TMS). MHCGM WILL IMPLEMENT THE FDA PROTOCOLS TO PROVIDE THIS TREATMENT FOR MILD TO MODERATE DEPRESSION THAT HAS NOT RESPONDED TO OTHER TREATMENTS. CURRENTLY OTHER PROTOCOLS ARE BEING CONSIDERED FOR FDA APPROVAL INCLUDING PROTOCOLS FOR SUBSTANCE USE DISORDER, ANXIETY, AND PTSD. BY IMPLEMENTING TMS WE WILL BE READY TO TREAT MORE PATIENTS AS THESE PROTOCOLS ARE APPROVED.

GREATER MANCHESTER HEATH SYSTEM ZERO SUICIDE PROJECT - THE GEOGRAPHIC CATCHMENT AREA FOR THIS ZERO SUICIDE IMPLEMENTATION INTO THE HEALTH SYSTEM IS THE GREATER MANCHESTER NH AREA, WHICH IS COMPRISED OF THE CITY OF MANCHESTER AND THE SEVEN TOWNS OF CANDIA, HOOKSETT, AUBURN, BEDFORD, LONDONDERRY, GOFFSTOWN, AND NEW BOSTON, AND DIRECTLY SERVES A POPULATION OF ABOUT 207K OR ABOUT 15% OF THE POPULATION OF NEW HAMPSHIRE. THE PARTNERS IN THIS ENDEAVOR INCLUDES A LEVEL 3 (CATHOLIC MEDICAL CENTER) TRAUMA HOSPITALS, THE VA MEDICAL CENTER OF MANCHESTER, AND THE MENTAL HEALTH CENTER OF GREATER MANCHESTER (MHCGM) AND WILL BE SUPPORTED BY THE MANCHESTER HEALTH DEPARTMENT, AMOSKEAG HEALTH, AND MANCHESTER SCHOOL DISTRICT. COMBINED THE PARTNERING ORGANIZATIONS ENGAGE WITH 250K+ PEOPLE A YEAR WHETHER AS PATIENTS OR THEIR FAMILY FROM THE GREATER MANCHESTER AREA AND ACROSS THE STATE. ALL OF THESE PARTNERS ARE LOCATED IN MANCHESTER, WHICH CONSTITUTES NEW HAMPSHIRE’S URBAN CENTER, AND IS A FEDERAL REFUGEE RESETTLEMENT ZONE. THE POPULATION OF MANCHESTER IS 77% WHITE, 10.5% HISPANIC, 5.5 % ASIAN, 4.2% BLACK/AFRICAN AMERICAN, AND 2.3% TWO OR MORE RACES. THE ISSUE WITH RISING SUICIDE RATES HAVE BEEN WELL DOCUMENTED ACROSS THE UNITED STATES BY THE WASHINGTON POST, USA TODAY, LOCAL AND NATIONAL NEWS JUST TO NAME A FEW. WHETHER IT IS THE 123 SUICIDES A DAY OR THAT SUICIDE IS THE NUMBER TWO CAUSE OF DEATH IN 10 TO 34 YEAR OLDS, OR THAT THERE ARE MORE THAN TWO TIMES THE NUMBER OF SUICIDE DEATHS AS THERE ARE HOMICIDES IN THE US, THE DATA IS STAGGERING. NEW HAMPSHIRE HAS NOT ESCAPED THESE ISSUES, IN FACT OVER THE LAST EIGHT YEARS THE SUICIDE RATE FOR NEW HAMPSHIRE HAS INCREASED EACH YEAR AND THE DATA FOR NH IS MUCH WORSE. SUICIDE IS THE 8TH LEADING CAUSE OF DEATH IN NH, THE STATE RANKS 17TH IN THE NATION FOR HIGHEST SUICIDE RATE AT 4.77 PEOPLE PER 100,000 HIGHER THAN THE NATIONAL RATE (18.77 TO 14.00), AND 5.2% OF ADULTS IN NH HAD THOUGHTS ABOUT SUICIDE WHICH IS HIGHER THAN THE NATIONAL (4.1%) AND REGIONAL AVERAGES (4.2%) . BEYOND THESE STATISTICS THERE ARE THE DISTURBING MENTAL HEALTH AND OTHER SOCIAL DETERMINANT DATA THAT PAINT A DARK PICTURE OF THIS ISSUE IN NH. THE NUMBER OF DRUG DEATHS PER 100,000 IN THE STATE OF NH IS 35.2 COMPARED TO THE NATIONAL AVERAGE OF 19.2, 19.7% OF YOUTH HAVE 2+ ADVERSE CHILDHOOD EXPERIENCES. ZOOMING IN CLOSER TO OUR PROPOSED SERVICE AREA THE STATISTICS GET EVEN STARKER. RECENT DATA HAS SHOWN THAT 13.4% OF ADULTS WITHIN THE SERVICE AREA REPORT FREQUENT MENTAL DISTRESS MORE THAN 1.2% HIGHER THAN THE NATIONAL AVERAGE . ACCORDING TO AMR MANCHESTER SUSPECTED OPIOID OVERDOSE REPORTS IN 2019 THERE WERE 568 OVERDOSES IN MANCHESTER WITH A 10% FATALITY RATE. MEANWHILE THERE WAS A 2016 DCYF REPORT THAT FOUND THAT 9.5% OF PEOPLE IN GREATER MANCHESTER HAVE EXPERIENCED 4 OR MORE ADVERSE CHILDHOOD EXPERIENCES (ACE). RESEARCH HAS FOUND THAT BOTH OF THESE FACTORS OPIOID USE AND EXPERIENCED ACES INCREASE THE LIKELIHOOD OF SUICIDE AND SUICIDAL THOUGHTS BY ALMOST 2 TIMES. THE GOAL OF THIS PROJECTS IS TO DECREASE THE SUICIDE RATE FOR PEOPLE 25+ WITHIN THE DESIGNATED HEALTH SYSTEM SERVICE AREA FROM THE CURRENT RATE OF 18.77 PEOPLE PER 100,000 TO BELOW 10 PER 100,000 WITHIN 5 YEARS AND CREATE A HEALTH SYSTEM THAT IS LEADERSHIP DRIVEN, SAFETY ORIENTED, AND COMMITTED TO REDUCING SUICIDE THAT HAS FULLY EMBEDDED THE ZERO SUICIDE MODEL WITHIN ALL IDENTIFIED HEALTH SYSTEM ORGANIZATIONS

TRAUMA RECOVERY THROUGH EVIDENCE BASED ACCESS AND TREATMENT - THE MENTAL HEALTH CENTER OF GREATER MANCHESTER (MHCGM)’S TRAUMA RECOVERY THOUGH EVIDENCE-BASED ACCESS AND TREATMENT (TREAT) PROJECT WILL IMPROVE ACCESS AND TREATMENT FOR YOUTH RESIDING IN CENTER AND WEST MANCHESTER COMMUNITIES (55% OF MANCHESTER YOUTH). TO ACHIEVE THE DESIRED RESULTS, TREAT HAS A THREE PRONGED APPROACH: EDUCATE THE COMMUNITY, PROVIDE ACCESS TO SERVICES, AND HAVE THE CAPACITY AND ABILITY TO DELIVER EVIDENCE BASED TREATMENT. TREAT’S FIRST PRONG WILL CREATE A TRAUMA INFORMED SUPPORTIVE COMMUNITY THROUGH TRAINING COMMUNITY MEMBERS, CHILD-SERVING SYSTEM WORKERS, AND POLICE OFFICERS IN THESE COMMUNITIES. BY THE END OF THIS FUNDING OVER 375 CHILD-SERVING SYSTEM STAFF, 150 COMMUNITY MEMBERS, AND 100 POLICE OFFICERS WILL BE TRAUMA INFORMED TRAINED AND AMBASSADORS TO REFER YOUTH TO SUPPORT AND TREATMENT. THROUGH THIS PROPOSAL TREAT WILL IMPROVE ACCESS BY PROVIDING THERAPIST TIME IN ALL THE SCHOOLS IN THE CENTER AND WEST COMMUNITIES AS WELL AS TIME AT CHILD-SERVING SYSTEMS LOCATIONS IN THE COMMUNITY. BEYOND THESE ON THE GROUND ACCESS POINTS WE WILL ALSO TRAIN 1 SCHOOLS A YEAR IN THE EVIDENCE BASED PRACTICE OF BOUNCE BACK (BB) AND COGNITIVE BEHAVIORAL INTERVENTION FOR TRAUMA IN SCHOOL (CBITS). THROUGH THIS ACCESS MATRIX 490+ YOUTH WILL BE REFERRED FOR SERVICES AND 407+ OF THESE YOUTH WILL BE ASSESSED OVER THE PROJECT PERIOD. WITH A TRAUMA INFORMED COMMUNITY AND AN INCREASE IN REFERRALS THE NEED FOR TREATMENT PROVIDERS WILL BE HIGH. SO TO ADDRESS THE 290+ YOUTH THAT WILL RECEIVE TREATMENT THIS PROJECT WILL ADD TWO TREATMENT PROVIDING CLINICIANS, 1 INTAKE CLINICIAN, AND 5 FAMILY COMMUNITY SUPPORT STAFF OVER THE GRANT LIFE CYCLE. MADE UP OF 12 DIFFERENT SCHOOLS THE YOUTH POPULATION (ABOUT 7,775 YOUTH) OF THE PROJECT IMPACT AREA FACES A NUMBER OF CHALLENGES. SIXTY-FIVE PERCENT OF THE YOUTH POPULATION QUALIFIES FOR FREE OR REDUCED LUNCH. FORTY PERCENT OF HOUSEHOLDS FALL IN THE HIGH OR EXTREMELY HIGH POVERTY RATE. THE VIOLENT CRIME RATE IS 10 TIMES THE AVERAGE RATE OF THE 500 BIGGEST CITIES IN THE US. THE COMMUNITIES ARE CONSIDERED A MEDICALLY UNDERSERVED AREA. A YOUTH RESIDING IN THIS COMMUNITY HAS AN OPPORTUNITY ATLAS FORECAST OF CONTINUED GENERATIONAL POVERTY. ADD TO THIS THAT EACH OF THESE FACTORS INCREASE THE LIKELIHOOD OF EXPERIENCING AN ADVERSE CHILDHOOD EXPERIENCE FROM WHICH TRAUMA AND TRAUMA BEHAVIORS CAN ARISE AND THE NEED FOR THIS PROJECT IS PARAMOUNT TO THE HEALTH AND WELL-BEING OF THESE YOUTH. TO ADDRESS THE TRAUMA THESE YOUTH HAVE EXPERIENCED THE CLINICIANS WILL IMPLEMENT ONE OF THREE EVIDENCE BASED TREATMENTS: CHILD PARENT PSYCHOTHERAPY (CPP), TRAUMA FOCUSED COGNITIVE BEHAVIORAL THERAPY (TF-CBT), BOUNCE BACK (BB), COGNITIVE BEHAVIORAL INTERVENTION FOR TRAUMA IN SCHOOL (CBITS), OR MODULAR APPROACH TO THERAPY FOR CHILDREN WITH ANXIETY, DEPRESSION, TRAUMA, OR CONDUCT PROBLEMS (MATCH-ADTC). DETERMINING WHICH TREATMENT IS THE BEST FIT FOR THE CLIENT WILL BE DONE THROUGH INTAKE AND THE USE OF THE CHILD AND ADOLESCENT NEEDS AND STRENGTHS (CANS) COMPREHENSIVE MULTI-SYSTEM ASSESSMENT AND THE UCLA PTSD SCREENER. AS A NON-PROFIT THAT HAS RECEIVED OTHER SAMHSA FUNDING WE WILL ENSURE TO IMPLEMENT WHAT WE HAVE LEARNED AND TRACKING PROGRESS AND OUTCOMES WILL BE STRICTLY FOLLOWED AND REPORTED SO THAT OTHERS CAN LEARN FROM THIS PROJECT AND MORE YOUTH CAN GET THE SERVICE AND CARE THEY NEED FOR THE TRAUMA THEY HAVE EXPERIENCED.

MAT STABILIZATION AND MAINTENANCE CLINIC

MENTAL HEALTH TRAINING FOR THE MANCHESTER COMMUNITY (MH4MC) - THE MENTAL HEALTH CENTER OF GREATER MANCHESTER’S (MHCGM) MENTAL HEALTH TRAINING FOR THE MANCHESTER COMMUNITY (MH4MC) PROVIDES SPECIFIC MENTAL HEALTH AWARENESS AND DE-ESCALATION TRAININGS TO COLLEGE/UNIVERSITY STAFF, LAW ENFORCEMENT OFFICERS (LEO), HUMAN SERVICES PROVIDERS, DIRECT CARE PROVIDERS, AND REFUGEE SERVICES PROVIDERS, WORKING THE GREATER MANCHESTER COMMUNITY. THE GREATER MANCHESTER AREA IS DEFINED AS CANDIA, MANCHESTER, HOOKSETT, AUBURN, LONDONDERRY, GOFFSTOWN, BEDFORD AND NEW BOSTON, NEW HAMPSHIRE. THIS AREA IS THE URBAN CENTER OF NEW HAMPSHIRE AND HAS A POPULATION OF ABOUT 207,000. MH4MC THROUGH ITS DESIGNATED COMMITTED PARTNERS WILL TRAIN 975 PEOPLE IN MENTAL HEALTH FIRST AID (MHFA), AND 100 LEOS IN CRISIS INTERVENTION TEAM TRAINING (CIT) UNDER THIS GRANT. CIT IS DELIVERED YEARLY TO 20 POLICE OFFICERS IN THE GREATER MANCHESTER COMMUNITY SO THAT OVER THE COURSE OF THE GRANT 100 POLICE OFFICERS ARE TRAINED. CIT IS APPROPRIATE FOR THE POLICE OFFICERS AS IT WAS DESIGNED SPECIFICALLY FOR THIS POPULATION AND ACCORDING TO A RECENTLY PUBLISHED ARTICLE IN THE JOURNAL OF THE AMERICAN ACADEMY OF PSYCHIATRY AND THE LAW, CIT HAS POSITIVE OFFICER LEVEL OUTCOMES INCLUDING SELF-PERCEPTION OF A REDUCTION IN THE USE OF FORCE AND INCIDENTS OF PRE-BOOKING DIVERSION FROM JAIL TO MENTAL HEALTH TREATMENT THUS IMPROVING THE RESPONSE TO PEOPLE IN CRISIS. MENTAL HEALTH FIRST AID IS DELIVERED TO 165 INDIVIDUALS IN YEAR 1, 180 IN YEAR 2, 195 IN YEAR 3 AND 210 IN YEAR 5 AND 225 IN YEAR 6. RESEARCH ON MHFA HAS FOUND THAT PEOPLE TRAINED IN THE PROGRAM HAVE AN INCREASE KNOWLEDGE OF MENTAL ILLNESS AND ADDICTION INCLUDING THE SIGNS AND SYMPTOMS, ARE ABLE TO IDENTIFY AND HELP A PERSON IN CRISIS ENGAGE WITH COMMUNITY RESOURCES, HAVE BETTER MENTAL WELLNESS THEMSELVES AND HAVE MORE CONFIDENCE IN HELPING A PERSON IN CRISIS. AS THIS TRAINING WILL BE TARGETED TO TRAIN RELEVANT STAFF ACROSS A WIDE SWATH OF THE MANCHESTER COMMUNITY POPULATION THE IDEA THAT THE PERSON TRAINED IN MHFA WILL BE ABLE TO RECOGNIZE SIGNS AND SYMPTOMS, HAVE THE COMMUNITY RESOURCE KNOWLEDGE TO DIRECT SOMEONE IN NEED, AND SUPPORT THEM THROUGH THAT PROCESS UNTIL PEOPLE WITH HIGHER LEVEL OF TRAINING ENGAGE WITH THE PERSON IN CRISIS IS A GAME CHANGER FOR OUR COMMUNITY.

SEE NOTICE OF AWARD, ATTACHMENT 1 - TERMS AND CONDITIONS, ATTACHMENT D, STATEMENT OF WORK, ABSTRACT.