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Drive underway to create mental health ‘center of excellence’


Dream big, then make things happen. In the same Vero tradition that produced centers of excellence for treating cancer, heart disease and stroke at a hospital that – thanks to another big dream – is now run by the Cleveland Clinic, a drive is underway to create a center of excellence for mental health.

Though discussions, led by the Hospital District, are only at the conceptual stage, the hope is that such a campus would be located near the hospital.

It would include a wide range of services, including 24/7 outpatient mental healthcare and inpatient detox, and an education component involving community outreach, as well as research and training opportunities for mental health practitioners.

Drawing inspiration from a table-top model of a recovery center that was never built, more than a dozen leaders of mental health-related organizations gathered around a conference table at Hospital District offices last week to start putting pen to paper on just what an ideal center would look like. 

The idea-sharing session followed an inaugural meeting in January attended by Cleveland Clinic Indian River’s president, Dr. Greg Rosencrance. According to Marybeth Cunningham, chair of the Hospital District board, Rosencrance challenged the group to think in terms of mental health needs “from birth to death and from preventive to curative.”

Cunningham also spelled out what not to consider at this stage – how to pay for it all.

“So, you’re building us a new community mental health center?” joked Brett Hall, executive director of the Mental Health Collaborative, as he eyed the handsome mock-up.

The answer, from the Hospital District’s executive director, Ann Marie Suriano, seemed only half in jest: “Maybe?” she teased.

Before long, teams of two and three were huddling. With the help of a facilitator brought in for the discussion, phrases like “one-stop shop” and “community hub” appeared on easel pads, and dreams for the scope of such a campus began to take shape.

Not only would multiple mental health services be provided with round-the-clock accessibility including by telemedicine and walk-in clinics, but educational outreach based at the campus would extend to preschools, churches and community groups.

With the prestige of the Cleveland Clinic name on the nearby hospital as well as on the existing inpatient Behavioral Health Center, the ideal campus would offer continuing education to psychiatrists from around the country.

Research opportunities might arise, and clinical think tanks could develop, along with practicums for students. Currently, agencies are dealing with what they say are constant calls from students around the state looking for such learning opportunities; the idea was floated to offer students common applications and even shared interviews with multiple agencies.

“There’s kind of a clinical vacuum in Indian River County,” said Anne Posey, director of the Behavioral Health Center. “This training institute could be the central training organization so that all schools have one place to call. It could really be in tune with all things psychiatric, with cutting edge research that clinicians want to talk about.”

“Who wouldn’t want to come to Florida in February for a week?” asked Hall, who went on to propose setting up real estate tours for doctors coming to take their required coursework, in the hopes of luring them to practice here.

Agency leaders spoke of wanting to destigmatize mental healthcare while coordinating funders and providers. They talked about the importance of integrating mental healthcare with primary healthcare, as Cleveland Clinic has done in its four primary care clinics by adding telepsych terminals.

“A surgeon general said 20 years ago that there is no health without mental health. That message has to be really clear as we move on, with primary care integration and screening,” said Sharon Packard, mental health coordinator for the county’s public schools.

“We can go into Publix and assess our blood pressure, but there’s no information about how our adverse childhood experiences affect our blood pressure,” said Packard. “Having universal awareness and screening agreements among our primary care providers is going to be huge.”

All participants agreed a shared central location would greatly help patients navigate the facets of care, “decreasing the number of steps for people to get where they need to go,” said Packard.

“I get calls all the time from people asking where do I go for this, who do I see?” said Posey. “It would be nice to have one community location where providers could see people and steer them where they need to go, whether it be on campus or to our own offices.”

There were also calls for a shared database within the complex, along with release of information among providers to ease the transition of client referrals.

While umbrella organizations located on campus could observe first-hand the services they are funding or coordinating, the campus concept would not mean providers would necessarily give up the offices they already have. “Having (the new center) as a common resource is really what we’re talking about. We want to keep the integrity of the organizations that are already intact,” said Vicki Soule, CEO of Treasure Coast Community Health.

Soule also spoke about the need for longer-term mental health support. “We always want to come in and just fix it,” she said. “But people take years to really get on their own two feet.”

Packard agreed. “We expect to see people routinely for diseases like diabetes, but behavioral health, you show back up and somehow you failed.”

Carrie Lester of the Substance Awareness Center spoke of “respecting that people will cycle in and out. They need to be able to enter back in at whatever point they left off,” she added.

Encouraging people to return for help comes with reducing the stigma of seeking mental health treatment in the first place. A centralized campus could help by having many services available at the same address.

A central location could also reduce overall costs by coordinating care more readily and avoiding duplication of services. Referrals could be simplified by having both generalist and specialist services available.

“There are a lot of people recognizing what a serious situation we have,” said the District’s Cunningham. “I want to have as much focus on mental health as we do on physical health.”