The Sidney Baer Center model of treatment is a showcase for what only recently in the United States is recognized as best practice for persons with serious mental illness (SMI). The Patient Protection and Affordable Care Act of 2010, written to reduce the costs of care while optimizing the quality of care, identifies two paramount treatment needs for persons with SMI:
1) the need for medical care at the same time as, and integrated with, psychiatric care
2) the need for psychiatrists and other mental health specialists to play a leading role in other professionals’ care of those suffering from SMI.
The Sidney Baer Center has been demonstrating this treatment, and its enormous successes, for more than 20 years.
The greatest driver of Medicaid costs is hospitalizations. And the predominant profile of those hospitalized are people with mental illness (70%), substance abusers (73%), and dual diagnosed (54%). Among those hospitalized, 60% have housing problems, 28% are homeless, and 24% are staying with family or friends.
Sixty-eight percent of persons suffering a mental health disorder have a comorbid medical problem, and 29% of those with a medical disorder have a comorbid mental health condition.
There are 600,000 persons in the mental health treatment system in NY, costing the State $7bn; the Substance Abuse system serves 250,000, at the cost of $1.7 bn. Fully 20% of these individuals, discharged from inpatient units, are readmitted within 30 days. (NYSDOH Medicaid Redesign Team report, 2011).
These figures illustrate a system of care which is at once exorbitantly expensive and dysfunctional. It offers neither an appropriate level of care, nor a full complement of needed services, to those in our society living with mental illness and co-morbid disorders.
Fountain House’s system of care, incorporating a full medical practice along with the core units of community, is a solution to the bleak picture described above. The Sidney Baer Center has been offering integrated care for many years, as well as referral for more intensive treatment if necessary. And staff has been coordinating with other staff at Fountain House to ensure that members receive services which can accelerate recovery - a safe place to live, friends and colleagues to reduce isolation, and the opportunity to work. This model of recovery works, it is inexpensive, and it is humane.
It should be emulated, and soon, throughout the world.
Madeleine Tramm, PhD
President, Tramm Consulting Group
Fountain House Council on Training, Education, and Advocacy