Delivery of Care

New investments made in prevention around mental, behavioral health

The Rhode Island Foundation directs funds from an insurance settlement toward a focus on addressing inequities in mental health, behavioral health services

Photo by Richard Asinof

Gov. Gina Raimondo talks about the new efforts to invest in prevention around mental health and behavioral health services, as Rhode Island Foundation President and CEO Neil Steinberg looks on.

By Richard Asinof
Posted 5/27/19
Grants totaling $2.6 million to increase access to preventive behavioral health and mental health care were announced by the Rhode Island Foundation on May 20, funded as part of a financial settlement with Blue Cross & Shield of Rhode Island.
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PROVIDENCE – A mere four days after the May 16 annual meeting of the Rhode Island Foundation, during which Neil Steinberg, the president and CEO of the community foundation, talked about the new initiative to create a long-term vision for health in Rhode Island, the Rhode Island Foundation held a news conference early Monday morning, May 20, to announce $2.6 million in grants to six nonprofit agencies, to address inequities and lack of access to behavioral health and mental health care in Rhode Island, beginning to put the words in that vision into action, with a focus on prevention.

The money is being distributed from a new Behavioral Health Fund at the Rhode Island Foundation, created in August of 2018, seeded with a $5 million contribution from Blue Cross & Blue Shield of Rhode Island, the result of a financial settlement with the R.I. Office of the Health Insurance Commissioner following a market conduct exam.

The six initial grants, which will be for three years each, were winnowed from 62 initial proposals requesting funds. They included:

The Center for Evidence Based Practice at Bradley Hospital in East Providence was awarded $291,072 to partner with the Village for Rhode Island Foster and Adoptive Families and the Institute on Stress, Trauma and Resilience at Brown University to provide intensive, evidence-based child behavior management training and parenting support to foster families, with the goal to promote children’s emotional and behavioral adjustment and reduce risk for negative long-term outcomes that are costly to society.

The Care Transformation Collaborative and PCMH Kids received $450,000 to test implementing a comprehensive Integrated Behavioral Health service delivery program to increase the identification and treatment of behavioral health conditions before people are in crisis. Eight pediatric practices will be selected to test developmentally appropriate and evidence-based screening tools and treatment models that address early intervention in childhood social-emotional challenges.

Clinica Esperanza in Providence was awarded $300,000 to support its Vida Pura program, which will provide care to low-income, uninsured Hispanic immigrants with unmet behavioral needs.

“It is well known that stress associated with political and gang violence is causing people living in South and Central America to flee their homes and migrate to the United States. The process of immigration increases that mental stress and, in the case of women who are subjected to sexual violence on the border, may even compound the stress many times over,” said Dr. Annie De Groot, the clinic’s volunteer medical director.

Clinica Esperanza’s Navegantes staff and volunteers will work with Sojourner House and medical and psychiatric residents at Brown University’s Warren Alpert Medical School. The goal is to have volunteers provide health services to immigrants in Rhode Island, many of whom have immigration-related experiences of significant first-order or second-order violence and who have turned to abuse of alcohol to ’treat’ their illness,” De Groot said.

The Coventry Public School District was awarded $440,356 to train educators, support staff, health workers, first responders and others who work directly with youth to identify early mental health needs.

“Bringing all agencies of Coventry together to address our young people’s mental health, substance use and other needs before they are in crisis is the primary goal,” said Coventry Public Schools Superintendent Craig Levis. “Everyone is needed; everyone is responsible.”

The initiative grew out of an increasing awareness that children from all demographics can suffer lifelong-lasting trauma due factors such as poverty, domestic abuse, homelessness, death of a loved one, divorce and sexual mistreatment.

The Rhode Island Association for Infant Mental Health was awarded $599,113 to provide specialized training for a wide range of professionals who serve infants, young children and their families.

“Our chance for positive outcomes for babies and families is strengthened when we commit to adequate training and support for our workforce. It’s best for babies when those providers who bear witness to a family’s deep struggles are supported with professional development and reflective supervision supports required to serve them well,” said Susan Dickstein, the association’s president.

Children under the age of three are the most likely to be homeless, live in poverty and experience effects of parental substance use disorders, maltreatment and neglect, according to Dickstein. “Breaking the cycle of adversity and promoting positive outcomes requires nurturing parent-child relationships. A key to success is a strong and well-supported infant/family workforce,” she said”

Rhode Island College was awarded $599,641 to develop and deliver evidenced-based screening and treatment services for Rhode Island’s most vulnerable and underserved populations using a fully integrated medical and behavioral health model of service delivery.

“This project will deepen existing relationships between the Rhode Island College School of Social Work and two primary care leaders: Thundermist Health Center and the Rhode Island Free Clinic,” said Jayashree Nimmagadda, project director and interim dean of RIC’s School of Social Work.

Focus on prevention
In announcing the grants and introducing the award recipients, Steinberg articulated the need to put more focus on prevention, rather than clinical intervention.

“The grants are centered on prevention,” Steinberg began. “We know we spend a lot of money on treatment.”

The six awards, he continued, will especially target communities that are disproportionately impacted by behavioral issues.

“For too many people, health care is still determined by their zip code,” Steinberg said. “When you can get to every zip code in the state of Rhode Island from this spot in 45 minutes, shame on us if we can’t figure out how to do this.”

The grants, he continued, will seek to expand alternative care models to address social determinants of health and promote system reform to improve both patient experiences and the health of populations.

“We want to do this work collaboratively,” Steinberg said, which he called one of the hallmarks of the grants. “Not only are these prevention models [to support] high-quality behavioral health [care], they also support evidence-based collaborative work.”

Springtime for Gina
Next to speak from the podium was Gov. Gina Raimondo. Outside the Rhode Island Foundation building, two handmaids had gathered in silent protest, marked by their red capes and white bonnets, as a way to keep the political pressure on the Governor to urge her to be more forceful in support of passing the Reproductive Health Care Act to protect the rights of women to make their own decisions about health care. Their presence was noted by a number of members in the audience attending the news conference.

Raimondo began by praising the warmer weather that had finally arrived and thanking Steinberg for his introduction.

Access to high-quality, affordable mental health services, the Governor said, has been a top priority in her administration. When she spoke about the issue in her state of the state address two yeas ago, some people had questioned whether that was an appropriate topic to be covered in the address.

“Absolutely,” Raimondo answered. “Because one in four adult Rhode Islanders have a mental health diagnosis. That means that every single person in this room has a friend, or a neighbor, or a family member, who is struggling with a mental health [disorder].”

Raimondo drew the comparison to diabetes, a chronic disease, where she said a person should be able to see a primary care physician to get the care needed, and to do that in a way that is affordable. “The same should be true for depression and anxiety, for whatever mental health issue you may be struggling with.” And, she added, it shouldn’t be that there are massive disparities in co-pays and insurances levels and access to care.”

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