A Consumer and Family Centered Mental Health System For Multnomah County

Created in August and September of 2000. Adopted by Multnomah County as Resolution 00-161

This document expresses the underlying vision and unifying philosophy that will guide the design and operation of public mental health services in Multnomah County. Consumers receiving mental health services (including adults, adolescents, children and families as appropriate) are at the center of the mental health system. The system is organized and operated to meet their needs. While there may be resource constraints the ultimate goal of the system is to improve the lives of those receiving mental health services.

The services for children, adolescents and their families will focus on a developmental model of intervention and on age and developmentally appropriate outcomes for children within the contexts of their individual family situations. The services for adults will be recovery-oriented with a focus on developing natural systems of support and self-determination. Within the adult and children service systems there may be different providers, programs and types of services but common values and principles will anchor and unify all mental health services.

Our vision for mental health services has three sections: attitudes and values; the service system; and accountability and management.

A. The attitudes and values of the mental health system support and encourage consumers to achieve their full potential.

1. Everyone receiving services in the Multnomah County Mental Health System is supported and encouraged to reach his or her full potential. Consumers are supported by attitudes and services that communicate hope, focus on strengths, nurture recovery, promote optimal development and support achievement of goals. Respect and dignity will be embraced throughout the County’s caring and flexible system.

2. The services provided by the mental health system in Multnomah County are individualized, and in the case of children, child-centered and family-focused. The needs, goals and preferences of consumers dictate the types and mix of services provided.

3. The mental health system is community based, with the location of services and decision-making resting at the community (i.e. local) level.< br />
4. Agencies, programs, services and staff are culturally competent; that is, sensitive and responsive to all the elements of consumers’ identities, including but not limited to age, ethnicity, race, religion, gender, sexual orientation, disability and culture.

5. Adult consumers may choose to identify friends, family members or others to participate in planning for their care and service delivery. The families and/or surrogate families of children receiving mental health services are full participants in all aspects of the planning and delivery of services.

6. Mental health services for children and adolescents will be guided by the best interests of the child or adolescent. Services will support, assist and strengthen the family system. This may include identifying and addressing changes needed to better support the child’s optimal development.

B. It is the goal of the mental health system to work toward the provision of a wide range of services that support recovery and optimal human development.

1. Services for adults maximize the opportunity for self-sufficiency, autonomy and a self-directed practice of recovery. Services for children reflect the “System of Care “ principles. Services and models for adults and children will evolve in response to consumer needs and evidence-based changes in best practices.

2. Services are provided in the least restrictive setting that is clinically appropriate and meets consumers’ needs. Services to achieve stabilization and recovery at lower levels of care are prioritized so that they are available when needed, thereby reducing utilization of higher levels of care such as crisis services and hospitalization. Services are organized to avoid inappropriate use of the criminal and juvenile justice systems as a substitute for mental health care.

3. Every person receiving mental health services has access to competent diagnosis and an appropriate an d affordable menu of treatment. Access to and coordination with competent, comprehensive physical health care is arranged.

4. Every consumer is assured of having a prompt and clinically appropriate response to his or her crisis and acute care needs.

5. Adult consumers have access to a range of safe, affordable housing options and the support services needed to successfully retain their housing over time.

6. Every person receiving mental health services has access to suitable employment, training and/or education services in order to reach his or her full potential for independence and contribution to society.

7. Every person receiving mental health services has access to a network of natural supports including transportation and affordable social, cultural, physical and recreational and/or faith-based activities that promote integration into the community, optimal development and recovery.

8. Competent care management services are provided based on need. Case managers insure that multiple services are delivered in a coordinated and therapeutic manner and that consumers can navigate smoothly through the system.

9. Services from multiple agencies including the education, criminal justice, juvenile justice, child-welfare, health and chemical dependency systems are coordinated and/or integrated to better serve consumers.

10. In order to support prevention and effective treatment, the mental health system provides consultation to other health and social service providers.

11. Mental health services include outreach and education in order to increase early identification and intervention and to increase appropriate continuation in care, leading to earlier recovery.

12. Consumers and families are able to access services easily. They are offered at convenient and accessible locations and times.

13. Services include consumers as providers and include opportunities for peer support and self-help. Services for children include opportunities for family peer support.

C. The mental health system is publicly accountable and well managed.

1. In order to be truly accountable the mental health system is organized with clear lines of responsibility and authority. The policy, planning, resource allocation and evaluation functions are centralized and consolidated and/or coordinated.

2. Consumers, providers, families and a wide range of stakeholders are involved in policy development, program planning, service delivery and evaluation for the mental health system.

3. The mental health system is publicly accountable for the resources that have been entrusted to it. Service delivery systems are integrated administratively to eliminate expensive fragmentation and duplication. Financial risk and incentives are utilized as tools to achieve system goals.

4. At all levels, the system is accountable for service delivery and outcomes. Clear, quantifiable measures are established to show efficiency and effectiveness. These measures include consumer satisfaction and improving the quality of life for people receiving services. The system uses data to monitor costs and outcomes and to improve quality and access.

5. A centralized data system is structured to increase coordination across service systems and provide the demographic, financial, service and outcome data necessary for system reporting, management and accountability.

6. The mental health system supports a positive working environment for its providers and staff. Competitive salaries and benefits, training and education and reasonable workloads reduce turnover and support the provision of high quality services and positive interactions with consumers

7. The system vigorously pursues new resources and partnerships that will help to meet the mental health needs of County residents. The system is expert at blending funds from a variety of sources to meet consumer needs.

8. Advocacy for the needs and rights of those with mental health disabilities is an important component of system management. Stigma and discrimination make recovery more difficult. Education and advocacy is carried out in order to increase understanding and support for consumers and families and their needs.

9. Critical incidents are investigated and, where appropriate, result in corrective action. A fair and consistent process exists to respond to grievances and complaints.