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Helping Mental Patients Avoid the ED

Like all of SCHA’s AccessHealth community-based networks, Tidelands Community Care Network (TCCN) manages state-funded Healthy Outcomes Plan (HOP) programs for partner hospitals in collaboration with the S.C. Department of Health and Human Services. For the past two years, TCCN has used the funds to connect patients with mental health counseling, in hopes of getting and keeping them in a long-term treatment program.

“The funds pay for three visits with the Waccamaw Center for Mental Health, which is part of the S.C. Department of Mental Health, to get patients established in therapy. After that they pay on a sliding scale,” said Kelly Kaminski, director of community health resources at Tidelands Health, which created and operates the Tidelands Community Care Network. The program reaches roughly 150 of their patients per year.

AccessHealth SC is an SCHA program that includes 12 networks that serve 36 counties, with TCCN serving Georgetown County. Through separate funding, TCCN also serves Horry County. It works by building a community-based network of care involving hospitals, free clinics, local health departments, community health centers, certified rural health centers, federally qualified healthcare centers, providers, social workers and other resources.

At Tidelands Health and Waccamaw Center for Mental Health, the HOP funds cover an initial intake session to determine what kind of counseling would be the best fit and follow-up visits with a psychiatrist and a counselor. “Patients self-determine if they want to participate,” Kaminski said. “We provide the option. We’re seeing greater retention this year. When we started, we would have a number of no-shows after one visit, but now more than 50 percent are utilizing the services and sticking to a treatment plan.

“Health care is confusing and health services are hard to navigate, and when you add that extra layer of behavioral health services, that’s another set of people and agencies that may not be coordinated,” she said. “We act as a care coordinator and case manager. Our patients build rapport with their case managers because this is someone they talk to every month, not a physician they see once a year. There’s a relationship built on trust. They have one point of contact helping them navigate not just Tidelands Health but also other resources.”

Kaminski says one of the biggest issues behavioral health patients have is managing medications. If they run out, many times they will go to the emergency department, where behavioral issues can escalate. Plus, “the ED is not going to give you a year’s prescription.” By connecting patients to primary care upstream and helping them monitor prescriptions, TCCN can help patients avoid unnecessary ED visits and manage their health.

Kaminski said it’s hard to say what impact the pandemic will have on demand for mental health services, but a Boston University study said half of U.S. adults surveyed reported experiencing anxiety and feelings of depression – double the rate from a similar study two years earlier.

“While we’re still in the pandemic it’s hard to assess. One thing we are seeing is a huge uptick in access to mental health services via telehealth,” she said. “We’ve also upped our virtual community classes.”