A long-term partner of Access Community Health Network (ACCESS), United Way of Metropolitan Chicago awarded ACCESS a two-year grant to expand its behavioral health services, which include mental health, behavior change and substance abuse disorder counseling services. The expansion, which has also been supported by the U.S. Department of Health and Human Services’ Bureau of Primary Health Care, is significant because behavioral health evaluation and treatment is an integrated part of ACCESS’ patient-centered medical home (PCMH) model of care. Going forward, ACCESS will be providing behavioral health services to almost 3,000 more patients per year.
Bethany Relyea, L.C.S.W., is part of the behavioral health team at
ACCESS. “I have been struck by the number of patients
who have been exposed to gun violence, domestic violence, sexual assault, or ongoing exposure to multiple and significant psychosocial stressors, including homelessness, food insecurity and unemployment,” Relyea said. She sees patients at ACCESS at Sinai health center in Chicago’s North Lawndale community and at ACCESS Located at Holy Cross health center in the Chicago Lawn community, and has worked with many patients who experience anxiety disorders, including many with post-traumatic stress. “Continued exposure causes a person to always be on the alert for danger, another threat or rejection, and may even cause nightmares and flashbacks, lack of concentration, and social withdrawal and isolation. These conditions also leave a person more vulnerable to depression, substance abuse and addictions.”
Relyea looks for ways to engage the patient in the present, working toward positive healthy outcomes. “When patients feel both genuinely heard and are offered ways of understanding their bodies’ response to trauma, this offers a doorway to healing psychological distress.” She continued, “The doctor’s recommendation to receive behavioral health support helps minimize the stigma associated with these services.”
“The need for an integrated system of behavioral health services and routine health care is huge,” said Jairo Mejia, M.D., ACCESS’ Chief Medical Officer. “However patients face barriers to getting such care when they live in underserved urban or suburban communities where such services continue to be cut at the local and state levels. It is also an issue for patients who don’t speak English fluently, which limits access to affordable services. These grants are enabling us to reach some of the region’s most vulnerable communities and patients.”
This funding, as well as additional support from The Chicago Community Trust and the Charles and M. R. Shapiro Foundation, Inc., makes it possible for ACCESS to expand services not only in the Chicago neighborhoods of North Lawndale and Chicago Lawn, but also in Chicago’s New City, Brighton Park, and East Garfield Park areas, and the Chicago suburbs of Addison, Bloom- ingdale, Blue Island, Chicago Heights, Cicero, Summit, and West Chicago. The Alfred Bersted Foundation, Bank of America, N.A., Trustee also supports expanded services in West Chicago.
Ximena Bravo, L.C.S.W., sees patients at ACCESS Martin T. Russo Family Health Center in Bloomingdale, Illinois. She says she sees many patients with anxiety and depression, as well as an influx of patients with heroin and alcohol abuse issues. She also sees a number of children who have been diagnosed with uncontrolled diabetes. “This can cause children to be confused, anxious, socially isolated and sometimes bullied due to their chronic illness,” she said. ACCESS’ medical providers – physicians and nurse practitioners – refer such patients to Bravo.
Norma Jones, L.C.S.W., is also part of the behavioral health team, and she has seen patients at ACCESS Family Health Society in Chicago Heights and ACCESS Blue Island Family Health Center. The physical and mental dispositions of a patient feed off each other. “For patients with chronic diseases such as diabetes and hypertension, good mental health affects maintaining and promoting good physical health, and poor physical health can result in declining emotional health,” said Jones.
ACCESS’ Genesis Center for Health and Empowerment behavioral health consultant Diana Sullivan, L.C.S.W., sees patients in Des Plaines who may not have been to a doctor for years and who have suffered trauma in other countries or local neighborhoods. “Some patients are isolated and have no one to talk to but their doctor, medical assistant or behavioral health specialist. Many of my patients speak Spanish,” Sullivan said. Some struggle with alcohol or other addictions. “Patients are amazed that they can partner with their health care provider to choose a treatment that is right for them and are glad to have the ‘one-stop’ services of both primary and behavioral health care at the same location.”
Thanks to grant support, ACCESS is now screening all patients for depression and substance use disorders.
ACCESS Women’s Health Director Charles Lampley, M.D., who specializes in maternal-fetal medicine, reports that statistics bear out the importance of a variety of behavioral as well as physical health screenings for expectant mothers. “We screen all expectant mothers for alcohol and substance abuse, domestic violence and depression. Twelve percent of our patients have issues with depression or we sometimes notice that they are concerned with other life issues,” he said. “If these problems go untreated, they can open up the door for postpartum depression or other issues that can be quite severe and affect both the mom and baby’s long-term health.”
The coordinated care team and patient-centered medical home model is a benefit for all patients. When new patients are seen at ACCESS, they are introduced to all available services that help support positive health care outcomes, including working with a single provider, on-site lab testing for select tests, behavioral health services, screening for health coverage and enrollment support for those who are eligible, plus linkage to other community and social services.