Maps and guides: improving navigation of the Maricopa mental health system

Featuring KER academic fellow Dawn Augusta

Reports of rising stress, anxiety, addiction, and depression have accompanied the events of 2020. This growing mental health crisis amplifies an alarm bell that health professionals have been ringing for some time: that our mental health system is falling short of helping many individuals maintain resilience in the face of shocks.

Health professionals refer to the crux of this problem as the “revolving door.” Patients appear to improve only to re-enter the mental health system and lose progress. When a crisis hits, it can become too burdensome for some people to keep up with appointments and manage medications.

During her fellowship, Dawn Augusta wanted to lay the foundation for long-term and short-term solutions by identifying where the system falls short. She started by working with local stakeholders to map the nodes and connections in Maricopa County’s publicly funded mental health system.

Augusta says that learning more about how people move through this system will help professionals develop holistic interventions. The approach could result in a more connected and cohesive design, capable of withstanding aggressive shocks. She and her team often received conflicting information from informants while building the map. “That shows the complexity of the system,” Augusta says. “There is just confusion — confusion for the people that are delivering the service. Imagine for the people that are trying to navigate the system!”

“We need a whole workforce on this problem, and that’s why I think taking this angle is resilient. We have to change the system through relationships.”

Until we can improve the system itself, we need to find better ways of helping people move through it. Augusta has a hunch that the best approach is to empower peer support specialists — people who have successfully navigated their own paths through the system and now work within it — by teaching them nurse coaching tools and skills.

To test these tools’ efficacy and model them in practice, she provided weekly coaching to ten peer support specialists.

“Nurse coaching is not trying to fix another person,” she explains. “It’s drawing from the strengths that the other person has to help them see a new path for themself, and it’s hopefully a path that exits the revolving door.”