Slide 1: One Care Implementation Council Meeting:  DMH Presentation
Commonwealth of Massachusetts 
Executive Office of Health and Human Services
Kathy Sanders MD
DMH Deputy Commissioner
January 12, 2021
Slide 2: DMH Mission and Vision
MISSION 
The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities.  Recognizing that mental health is an essential part of healthcare, the Department establishes standards to ensure effective and culturally competent care to promote recovery.  The Department sets policy, promotes self-determination, protects human rights and supports mental health training and research.  This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers and communities. 
VISION
Mental health care is an essential part of health care. The Massachusetts Department of Mental Health, as the State Mental Health Authority, promotes mental health through early intervention, treatment, education, policy and regulation so that all residents of the Commonwealth may live full and productive lives.

Slide 3: DMH Statistics
•	Massachusetts Population:  6,850,55
•	Citizens with Severe Mental Illness and functional impairment (across the life span):  348,436 
•	DMH serves 25,400 individuals including approx. 3,800 children and adolescents.  
o	Of that number, 663 are served in DMH continuing care inpatient facilities. Most clients are served in the 	community. DMH also serves approx. 8,000 individuals who are forensic/court referred.
Slide 4: DMH Service Authorization
•	Most mental health services, including medication and therapy, are provided through health insurance
•	DMH provides supplemental, specialized services for people with the most serious needs to support these individuals so they can live fully in the community
•	These services require approval by DMH. Some DMH services can be provided short-term while DMH is completing a clinical review and/or to meet a short-term critical need 
•	Approximately 25,000 individuals are currently authorized to receive DMH services
•	Determining whether to authorize DMH services for an individual depends on an assessment of whether:
o	Individual meets the clinical criteria for DMH services; 
o	Individual requires DMH services and has no other means for obtaining them;
o	DMH has available capacity. 
Slide 5:  Eligibility for DMH Services
1)	Diagnostic eligibility: Does the individual have a condition that is eligible for our services?
•	Adults >22 years old
A.	Serious, long term mental illness
B.	Functional impairment
C.	Qualifying diagnosis – Primary cause of impairment
•	Psychoses; Mood; Anxiety; Dissociative/Eating/Borderline and Trauma Disorders
D.	Excluded diagnoses – Cannot be Primary cause:
•	Substance Use; Medical/Trauma; Neurocognitive & Neurodevelopmental Disabilities; Dementia 	
Slide 6: Eligibility for DMH Services
•	Children = under 22 years old
A.	Serious emotional disturbance
B.	Qualifying mental, emotional or behavioral disorder
•	Any DSM diagnosis that significantly impairs functioning
C.	Functional impairment persists for one year
D.	Excluded diagnoses
•	Same as for adult (substance use; medical/trauma; cognitive & developmental disabilities; dementia)
Slide 7: Eligibility for DMH Services
2) “Needs & Means”
•	Does DMH offer a service that will benefit the individual?
•	Does the individual lack any other means of obtaining that service?
–	Other Insurance
–	Other Agency involved
Slide 8: DMH Services
•	Community-based Services include:
•	Adult Community Clinical Services (ACCS)  
•	Program of Assertive Community Treatment (PACT)
•	Clubhouses
•	Case Management
•	Recovery Learning Communities
•	Forensic - Court Clinic, Jail Diversion and Re-entry Services
•	Respite Services
•	Homeless Support Services
•	Child, Youth and Family (CYF) intensive home-based services
•	CFY Flexible Support Services
•	CYF Day Treatment/After School Services
•	CYF School and Community-based Support Services
•	Young Adult Access Centers
Slide 9: DMH Services: Brief Descriptions
SERVICES And DESCRIPTION
Inpatient/Continuing Care System: DMH-operated psychiatric inpatient facilities: two psychiatric hospitals; psychiatric units in two public health hospitals; five community mental health centers that promote treatment, rehabilitation, recovery.
Adult Community Clinical Services (ACCS): The DMH community service system: Rehabilitation, support, and supervision with the goal of stable housing, participation in the community, self-management, self-determination, empowerment, wellness, improved physical health, and independent employment using evidence-based practices.
Respite Services:	Respite Services provide temporary short-term, community-based clinical and rehabilitative services that enable a person to live in the community as fully and independently as possible.
Program of Assertive Community Treatment (PACT): A multidisciplinary team approach providing acute and long-term support, community based psychiatric treatment, assertive outreach, and rehabilitation services to persons served.
Clubhouses: Clubhouse Services provide skill development and employment services that help individuals to develop skills in social networking, independent living, budgeting, accessing transportation, self-care, maintaining educational goals, and securing and retaining employment.
Recovery Learning Communities (RLCs): Consumer-operated networks of self-help/peer support, information and referral, advocacy and training activities.
DMH Case Management: State-operated service that provides assessment of needs, service planning development and monitoring, service referral and care coordination, and family/caregiver support.
Emergency Services (ESP): Mobile behavioral health crisis assessment, intervention, stabilization services, 24/7, 365 days per year.  Services are either provided at an ESP physical site or in the community.
Homelessness Services: Comprehensive screening, engagement, stabilization, needs assessment, and referral services for adults living in shelters.
Child/Adolescent Services: Services include case management, individual and family flexible support, residential, day programs, respite care and intensive residential treatment.
Forensic Services: Provides court-based forensic mental health assessments and consultations for individuals facing criminal or delinquency charges and civil commitment proceedings; individual statutory and non-statutory evaluations; mental health liaisons to adult and juvenile justice court personnel.