Maine mental health organizations join forces to coordinate care

Maine mental health organizations join forces to coordinate care
(May 2009 Issue)

By Ami Albernaz

In order to disseminate mental healthcare more effectively and reach a larger pool of Maine residents, mental health organizations are joining forces as Maine Mental Health Partners (MMHP), which will coordinate care for residents of 11 counties in the central and southern parts of the state.

The partnership, announced in late February, aims to reduce redundancies, streamline care and improve access to services at a time when funding cuts have winnowed down mental health care options that were already lacking in some areas of Maine.

"Our vision clearly is to provide support for the region of Maine we serve. Hopefully the citizens we serve will benefit from interacting with Maine Mental Health Partners," says Dennis King, president of the partnership and CEO of Spring Harbor Hospital in Westbrook, Maine.

Founding members of MMHP are Spring Harbor Hospital, which provides inpatient and outpatient psychiatric services and Maine Medical Center's Department of Psychiatry. Newer members include Integrated Behavioral Healthcare, a private psychiatry practice in Scarborough and Community Counseling Center in Portland. The partnership aims to include organizations throughout the MaineHealth region.

The importance of improving efficiencies in Maine's mental health system was pointed out in early March, when a report issued to Kennebec County Superior Court found the state was out of compliance with a longstanding agreement to improve services for people with serious mental illnesses.

"There are [MaineHealth] members that have psychiatric programs and services scattered around the region," King says. "The question is how you get these services to the outermost parts of the region, where you most likely won't have a psychiatrist there at all."

Although the logistics are still being worked out, King expects the partnership might take advantage of telemedicine or primary care practices that include mental health clinicians. "They back up the practice in the sense they're located in the practice," King says. "If you send a psychiatrist into a rural area, [slots] tend to get filled up fast."

Member organizations pay a small fee to belong to the partnership, though savings in operating costs are expected to far outweigh this fee. Girard Robinson, M.D., MMHP's vice president of Medical Affairs and Chief of Psychiatry at Maine Medical Center, says the partnership will look to streamline medical assessments and use electronic records, as well as fill gaps in existing services.

"The idea is to have the full continuum from inpatient to outpatient care," Robinson says. "We need to think about a system of care, not just individual entities."

Planning for the MMHP began almost two years ago, though Spring Harbor Hospital and Maine Medical Center's Department of Psychiatry have long had an integrated administrative and clinical management structure. As Spring Harbor began serving a larger geographical area and working with other facilities, the partnership began to make sense, Robinson says.

"I think there's a lot to be said for economies for scale and unifying the system, but we don't want to spread ourselves too thin," he says. "We're going to be operating on a new scale."

MMHP does not seek out members, but lets interested organizations approach the partnership, says Brian Rines, Ph.D., an MMHP board member and longtime forensic psychologist in Augusta, Maine. Each potential new member is evaluated to learn what expertise it can offer and what gaps in the care continuum it might fill.

In addition to hearing from organizations that are looking to reduce costs, "we're also being approached by people who are economically sound now and want to have a sound model many years from now," Rines says.

By providing better-targeted services to residents, MMHP planners hope to reduce hospital stays and emergency room waits, fulfilling the court mandate to provide better mental health care.

"We can no longer afford 25 silos [of care]," Rines says. "So we're working to do what needs to be done."