Mental Health and Substance Use Disorder

children’s health including infant mortality. While the positive impact may not be seen in the short term, our expectation is that over time, the health of all family members will be improved by addressing these needs. As will be discussed in more detail later in this document, ChristianaCare has made a strong commitment to addressing the whole health of our patients, including their social care needs.

Mental Health and Substance Use Disorder

As indicated by every Community Health Needs Assessment we have undertaken, our community needs more accessible behavioral health services. ChristianaCare is undertaking a bold plan focusing on recruitment and the development of new programs and models to address behavioral health both inside and outside of our clinical spaces. We expect our efforts will allow for increased access both virtually and in-person, reduce length of stay for long-stay patients, and reduce inappropriate emergency room utilization. In fiscal year 2022, we set the ambitious goal to hire 71 new caregivers in both clinical and non-clinical roles to address behavioral health by the end of fiscal year 2023. As of September 2022, 57% of those positions have already been filled. ChristianaCare, like hospitals throughout the country, has experienced hiring difficulties, particularly when it comes to behavioral health professionals, but we are pleased with the progress we have already achieved toward our bold goal and optimistic that it will be achieved. We are underway in developing new and expanded programs to increase access to Behavioral Health services. These include:

• Gender Wellness Clinic which launched in October 2021 and includes three gender therapists that support anyone age 13 or older exploring their gender identity, experiencing gender dysphoria, or who needs education and support around social and medical transition • First Episode Clinic is an early intervention model designed to connect patients with resources to reduce inappropriate ED visits and readmission to inpatient floors. This will launch in 2023. • Efforts to support a new Geriatric Mental Health program are underway with the recruitment of two new Senior Psych Social Workers and a Geriatric Psychiatrist in collaboration with ChristianaCare’s Swank Memory Center. • A return to Group Therapy Programs for adults and children now that COVID restrictions have eased. ChristianaCare’s Substance Use and Embedded Behavioral Health Care Models are also expanding. • An Advanced Practice Clinician is now embedded within Project Recovery, ChristianaCare’s outpatient substance use disorder treatment program.

• ChristianaCare Behavioral Health is exploring operations opportunities in the ED to facilitate connection into psychiatry and psychology services. • ChristianaCare will expand embedded Behavioral Health into new practices. • With the addition of two new Behavioral Health Consultants (BHCs), ChristianaCare BHCs are now serving six Women’s Health Practices. ChristianaCare’s Child and Adolescent Care Model is also expanding with the hiring of two new Child & Adolescent outpatient therapists (Dec 2021 and Jan 2022) to support our psychiatric population. As shared in a prior section, ChristianaCare intends to provide more behavioral health services in School Based Health Centers ensuring young Delawareans have true access to therapeutic support. The new and expanded programs above, along with ChristianaCare’s recruitment efforts, will provide more access to behavioral health services to our diverse community. ChristianaCare is also employing Community Health Workers to serve patients in Behavioral Health, including the Behavioral Health CHW program, launched in 2021 to serve patients in adult outpatient and Project Recovery. Like the other CHW programs, this one is also focused on assisting the patient in meeting their goals and addressing their social determinants of health. In 2020, ChristianaCare partnered with the New Castle County Police Department (NCCPD) to support the NCCPD’s efforts to address mental health and substance use disorder in the community. Two ChristianaCare employees are embedded in the police department to respond to 911 calls and officer referrals when mental illness is believed to be a primary factor for police involvement. The role of this team is to both provide support to the community member at a time of crisis as well as to provide supportive education to the officers on how to identify mental illness and essential de-escalation tactics. The caregivers work to connect these individuals to the appropriate community treatment and to address any social needs. Three other ChristianaCare employees support the NCCPD’s Hero Help Program which addresses substance use disorder by supporting those seeking treatment. These employees respond to non-fatal overdoses, provide outreach in the community, work with individuals to devise a treatment plan and obtain treatment, provide ongoing case management, and address any needs individuals may have that serve as barriers to obtaining treatment. This partnership is currently supported through grant funding which will end in October 2023, however, ChristianaCare intends to explore resources to continue this important behavioral health partnership through a new access point.