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Tia Burroughs Clayton, MSS
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Chief Operating Officer

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Vice President of Learning & Community Impact

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Caitlin O'Brien, MPH
Director of Learning & Community Impact

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Tyrone Quarterman, BA, MPH Candidate
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Georgia Kioukis, PhD
Consultant

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Trauma-Informed Person-Centered Enrollment Process

Mental Health Association of Rockland

Trauma-Informed Person-Centered Enrollment Process Logo

Program Website
Year:
2018
State:
New York
Winner Status:
Applicant
Program Type:
Policy and Systems Change
Target Population:
Individuals with Serious Mental Illness
Setting:
Clinic

Program Description

The Program of Self-Discovery (Pros) is a program serving adults diagnosed with mental illness or co-occurring illness. Our innovation focused on Creating a” trauma informed person centered enrollment process”. Former process: 1. Screen the person in or out 2. Request documentation before appointment 3.Intake staff interview , obtain detailed accounts of the most painful moments of the persons life 4.If accepted assign a clinician, ask similar questions (recounting) Innovative Trauma informed person centered process 1. Invite guests to a “getting to know you meeting” 2. Offer refreshments/ tour and one two one conversation with a clinician 3. Assessment requirements eliminated from this first encounter 4. Offer the option to audit classes accompanied by a peer mentor 5. Those choosing to stay for lunch, dine with the peer who introduces them to others 6. End the day by speaking to an administrator about the experience. Sharing likes and dislikes . 7. Choosing to work with the clinician they met with or another 8. If they decide not to stay we discuss options and will assist with a referral 9. Send a post card or letter thanking them for coming in and leaving the door open for the future

Creativity

We desire to effectively engage new comers so they are not lost to process. Our members shared with us that when they first came, they felt uncomfortable and overwhelmed with questions and the intensity of needing treatment. The space had an impact on how comfortable and welcomed or cold and unwelcomed they felt ( see video) Our Peers and staff helped changed the process to make it trauma informed and person centered Key components- 1.Agency wide Trauma informed care training 2. Merged intake role and clinician role 3. Stopped interviewing and started getting to know you meetings 4. Started talking about our program , what we do, and how to partner 5. Removed paperwork from the first encounter 6. Treated first timers as guests 7. Added peer mentors to the process- introducing them to classes of interest 8. Encourage auditing classes 9. Asking not telling 10. Respecting their choice

Leadership

The first thing that the organization leadership did was to train all staff ( not just clinical) in trauma informed care. Once all staff was trained, and understood how participants can be re-victimized ,each program began looking for what in their practice was not trauma informed, welcoming or helpful for the people we are serving. In the PROS program, we looked at the intake process, the waiting area, length of the interview , who the person shares personal information with and determining if each step is necessary. We began the work of identifying and removing artificial barriers. We asked current members their feelings about parts of the process and how to make it better. We formed a team of peers and made them part of the first people the new visitor meets. The visitor received insight on the program from a peer- “one who been there done that”

Sustainability

Staff and peer commitment was necessary to implement and sustain the initiative. The team n acknowledged the strength demonstrated in entering a mental health facility and built on that strength. The second was leadership support. The willingness to invest resources to create spaces and time to accommodate this approach. The third step for sustainability is willingness to revise parts or all of the steps to adjust to individual differences ( not a one size fits all modality). The hospitals and clinics that are referring to us, are delighted. We have removed the need to ‘sell” candidates. We are welcoming all who come and making the effort to engage those who don’t think they need help. We work with them across the various stages of change( pre-contemplative to action). Finally those who don’t choose our service remember us as a welcoming place, that they can come back to in the future.

Replicability

The initiative is transferable because it is in keeping with trauma informed care and person centered practice. The first step is to determine by survey or by reviewing complaints how people feel when they come to your agency. The second step is to evaluate why people stay or don’t stay, (do they complete treatment). The most important step is to put the “Human” back into Human services. In many ways we had lost sight of the people because of the mandates for paperwork, evaluations, reports and data collection. We have managed to move those mandates out of the first meeting. We don’t have any responsibility beyond getting to know what the person wants us to know about them and why they are here. We make them comfortable first and get into the weeds later.

Results/Outcomes

We began utilizing the new method on December 1, 2017. * We encountered 20 persons using the new practice. 12 have been admitted to the program with the majority enrolled after the first getting to know you meeting. * 4 people remain in the process of auditing groups as they have not made the decision to enroll *1 person is awaiting discharge from the hospital before he can be enrolled in the program( however he is auditing groups ) *3 people declined after auditing the groups- two said they were not ready for treatment and one stated that she could not tolerate groups Operating in our prior system, we found that people would not return after the first intake or soon after enrollment. All of the clients entering via the new process have maintained engagement which we assess by their continuing to attend and dialogue with us.