MHSC Program Evaluation Mental Health Service Corps. Dana Collins, Social Work Intern Jessica Neufeld, MPH Virna Little, PsyD, LCSW-r, MBA, CCM, SAP

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1 MHSC Program Evaluation Mental Health Service Corps Dana Collins, Social Work Intern Jessica Neufeld, MPH Virna Little, PsyD, LCSW-r, MBA, CCM, SAP

2 Background & Rationale & Goals The Mental Health Service Corps (MHSC) is a program aimed to promote and protect the wellbeing of all New Yorkers. A program evaluation was conducted by the Institute for Family Health to identify the impact of MHSC s social workers on their assigned client base, centers, providers, and the utilization of MHSC in community health centers. The goal of this evaluation was to determine the impact of MHSC in an FQHC placement.

3 Project Details Setting: Walton Family Health Center, Urban Horizons Family Health Center, Stevenson Family Health Center, Sidney Hillman/Phillips Family Practice, Family Health Center of Harlem (one MHSC social worker was placed in each of these sites) Method: Continuous Quality Improvement Project (CQI) Timeline: September 2016 January 2017 Subjects: Four social workers from the MHSC program and their patients

4 Methods The MHSC social workers and their patients were examined based on factors such as patient demographics, patients clinical outcomes, types of appointments/outreach, and social worker capacity and productivity.

5 Programs & Tools Used EPIC Database of all patients that includes all interactions between the Institute and patients, current and past conditions, treatment plans Productivity & Capacity Data Book (2016) Monthly report about productivity and capacity for each mental health clinician Used to compare the MHSC social workers with the IFH social workers and staff Patients Health Questionnaire (PHQ-9) A multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression Done multiple times (every visit), which can reflect if the patient is improving in regards to their depression due to their treatment plan Used to examine the changes in PHQ-9 scores since the MHSC social workers started working with their patients Columbia-Suicide Severity Rating Scale (CSSRS) A suicide risk assessment that helps identify whether someone is at risk for suicide, assess the severity and immediacy of that risk, and gauge the level of support that the person needs Used to record the number of CSSRS and safety plans were conducted since the MHSC social workers started MHSC SW & IFH Staff Survey To explore the relationship between IFH staff and MHSC social workers

6 Percentages for various performance measures IFH Regional Performance Measures (NYC) 150% 140% 130% 120% 110% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% Productivity [Actual Visits Completed / Visit Projection] Capacity [Visit Time Spent / Availability] Appointment Conversion Rate [Actual Visits Completed/Intended Visits] Availability [Hours] Actual Visits Completed 0% Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Performance by month 0

7 Productivity and Capacity Levels (%) MHSC Productivity & Capacity 100% 90% 82% 84% 88% 91% 80% 70% Capacity Level 64% 76% 68% 62% 60% 50% 40% 30% 20% 30% 47% 40% 26% 36% 33% 21% 44% 55% 36% 48% 50% 40% 10% 0% 2% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Productivity Capacity Productivity Capacity Productivity Capacity Productivity Capacity September October November December SW 1 SW 2 SW 3 SW 4

8 Types of Visits/Encounters Types of Visits/Encounters /Letter Telephone Non-Visit No show Canceled In Person/ Completed Visit SW 1 SW 2 SW 4 SW 4

9 Most Common Items on Patient Generalized Anxiety Disorder/Anxiety, 15% Suicidal Ideation, 15% Depression, 35% Problem List Substance Abuse, Adjustment 6% Disorder, 5% Other, 12% Post-Traumatic Stress Disorder, 4% Insomnia, 3% Suicide Type 2 Diabetes, 3% Pre- Diabete s, 3% Attempt, 3% Depression Generalized Anxiety Disorder/Anxiety Adjustment Disorder Pre-Diabetes Insomnia Suicidal Ideation Substance Abuse Post-Traumatic Stress Disorder Type 2 Diabetes Suicide Attempt *The conditions shown here are only based on the total number of patients from all four of the MHSC social workers

10 Average Last PHQ-9 Score Per Month Depression Metric October 0 November December January SW SW SW SW Depression Scores Per Month

11 Safety Plan and C-SSRS Rates Safety Plan C-SSRS Total Patients SW SW SW SW Note: This table only includes patients who had suicide on their problem list.

12 Discussion MHSC social workers met with a variety of clients, though most came with a history of depression Productivity and capacity varied among the MHSC social workers and slowly improved over time Safety plan and C-SSRs need to be addressed and conducted more with clients

13 Limitations Data for this evaluation was very preliminary; the MSHC social workers had been working with IFH for roughly 5 months at the time of this evaluation was done Sample size is very small; there were only four MHSC social workers examined for this program evaluation Also, one of the MHSC social workers was on leave for a few months and had only returned for one month (her data was included in this evaluation)

14 Recommendations To conduct monthly program evaluations examining the same variables and characteristics past evaluations have looked at To continually meet with the MHSC team to discuss gaps and how to improve collaboration between MHSC and IFH

15 Dana Collins Social Work Intern Psychosocial Services Contact Information Jessica Neufeld, MPH Special Projects Coordinator Psychosocial Services Virna Little, PsyD, LCSW-r, MBA, CCM, SAP Senior Vice President Psychosocial Services/Community Affairs