This is sort of similar to what I am developing except I am looking more at proving support for people with significant mental illness. What I don’t see are licensed clinicians providing services. That is a bit of a problem from my perspective. There is a local program in this community that is doing something similar and farms out the clinical work to community providers. This model ends up with case managers and other unlicensed folk having too big a role in clinical decisions.
Also, despite the way they are marketing it, most of the patients that needs this extra level of support are going to have significant mental health concerns so I would like to see an integrated team providing the treatment. They try to avoid this aspect by calling it support. That is misleading and it is really more useful to think of it as a continuum of treatment with this in between residential and just outpatient once a week therapy with no additional supports. Having clarity of your mission is key to providing effective treatment.
I also think that this population needs close coordination between all of the team members including those who are prescribing the medications. The only really functional multidisciplinary teams I’ve seen is where the psychiatrists are integrally involved in the care and don’t make decisions unilaterally. If the psychiatrist isn’t in the room and is relegated to med manager role, that leads to really bad care Just because a patients medications aren’t being changed shouldn’t mean that the psychiatrist has no role. I appreciate the extra set of eyes and ears on the case myself and find that the patients discussion with psychiatrist and the doctor’s assessment will often yield valuable information to guide my treatment. It works the other way too on a functional team.
I digress a bit mainly because all of my thoughts are geared in one direction right now as I develop this type of program myself and think through what it would look like.
mansfieldhall.org
