Selected Podcast
Ep. 17: Innovative WellSpan Philhaven START Clinic Opens in York
On this episode of Inspiring Health, we’re exploring another WellSpan innovation, specifically around our work to find a better way to care for vulnerable members of our community by increasing access to coordinated treatment in a certified community behavioral health clinic.
Featuring:
Mitchell Crawford, DO | Roxanna Gapstur PhD, RN
Dr. Crawford is Director of Addiction Services for WellSpan Philhaven, and also serves as the Medical Director for the START clinic. He provides support and creates clinical services for the treatment of addiction throughout the system. He has received specialized training in the treatment of substance use disorders and is an advocate of medication assisted treatment for patients, which uses medications in combination with counseling and behavioral therapy. Transcription:
Roxanna Gapstur: In this episode of Inspiring Health, we're exploring another WellSpan innovation specifically around our work to find a better way to care for vulnerable members of our community by increasing access to coordinated treatment in a certified community behavioral health clinic.
So today, we'll talk about the innovative care delivery model being used within WellSpan Philhaven's START Clinic based in the city of York. And we'll talk about how we're creating an inclusive environment for the treatment of complex and diverse patients, as well as the community partnerships that are supporting these services and how are collaborations designed to reduce incarceration rates among individuals charged with minor crimes that are really related to mental health and addiction within our communities.
Joining me today is Dr. Mitchell Crawford. Dr. Crawford is the Director of Addiction Services for WellSpan PhilHaven and he also serves as the Medical Director for the START Clinic. He provides support and creates clinical services for the treatment of addiction throughout our whole health system and has received specialized training in the treatment of substance use disorders. He's an advocate of medication-assisted treatment for patients which uses medications in combination with counseling and behavioral therapy. Dr. Crawford, thanks for being here.
Dr. Mitchell Crawford: Thank you so much, Roxanna. It's my pleasure to be here to represent our wonderful team at the START Clinic.
Roxanna Gapstur: Well, let's start out talking about WellSpan Philhaven START Clinic and how that was made possible by a 4-million federal grant, the largest grant awarded in WellSpan's history. And in my opinion, it's an honor for WellSpan to have been recognized as a worthy steward of those dollars and to be able to put our mission into action with the certified community behavioral health clinic or the START clinic.
START stands for Specialized Treatment And Recovery Team and the care delivery model that we're using in the clinic is the first of its kind here in South Central Pennsylvania. Mitch, can you share with me what makes that model so different from traditional methods of treating mental health and substance use disorders?
Dr. Mitchell Crawford: Absolutely. And thank you so much for your kind comments about the program, Roxanna. START has two overarching principles, to provide access to treatment and to stabilize acute need that our program participants may have so that they can achieve their goals. The central question is what is most important to you right now? And how can we help?
START utilizes evidence-based approaches to care such as cognitive behavioral therapy, motivational interviewing, medication-assisted treatment for substance use disorders among others. The program works as a team to help the participant with what is important to them, whether that be services we provide internally or through one of the many community organizations we collaborate with.
When we take this approach, it makes it possible for us to deliver the right care in the right place at the right time. For example, I specialize in treating addiction and, if someone came to START, who was diagnosed with a substance use disorder and I put blinders on and only saw the addiction need, I could create what I believe to be a helpful treatment plan for them. But if they were actually coming to START to ask for help with food insecurity, and I didn't understand that, I would miss an opportunity to connect with and serve that person. When we show that we care by asking what is important to the participant and work with them on that goal, it builds an alliance that can lead to the goal of whole health.
A recent real example is that one of our team members was contacted by someone who expressed anxiety about their medications not being able to be filled at a local pharmacy following discharge from the hospital. A nurse in the program was brought into the visit and helped remedy the situation. Feeling heard, the program participant then shared that they had been drinking more than they would like, so a recovery support specialist was then brought into the visit. And they were able to schedule an appointment together shortly after to work on that new goal together. Working as one, the program found a better way of meeting the needs of the participant. And lastly, I think it's important to note that this treatment approach has helped relieve stress from other parts of the system. For example, of the many participants treated, 183 of them were diverted from the emergency department that we know of.
Roxanna Gapstur: Wow, Mitch. We know it's important to treat the whole person and it sounds like we're already seeing results from our START clinic. Yet when we think about what impacts a person's health, a lot of that happens outside of our care. And we've long talked about the impact of social determinants like food and housing insecurity, which you just mentioned, and the care model that's used in the clinic helps us address these issues and others that impact the health of individuals. Is that right?
Dr. Mitchell Crawford: That's exactly right, Roxanna. When we ask what we can be helpful with, the responses we receive are often related to social determinants of health. A good example of how the program addresses this is that START partnered with the York Hospital Food Service staff to provide My Own Meals. My Own Meals provides two to three days' worth of shelf-stable meals while the team works with collaborating partners towards longer-term solutions. This program became available to START participants on June 15th.
Roxanna Gapstur: That's really amazing. Gosh, the START clinic began seeing patients remotely in December of 2020. And I think by the time we opened the doors to the physical location in early May, we'd already served 400 patients. Were you surprised by the number of patients we serve so quickly, Mitch?
Dr. Mitchell Crawford: I was impressed, but not surprised. Michele Crosson, who is the project director at START is doing a fantastic job leading a great team. We also purposely chose York as the location after review of key data points. In York, 35% of residents live below the poverty level according to US census figures. Additionally, more than 65% of residents also reported at least one day of depressive symptoms in the previous two weeks according to the York County Community Health Needs Assessment. County health rankings also show that there is a shortage of mental health providers, which is one provider for every 920 residents. The need was so great in the York community and we were eager to help our neighbors and residents finally get a healthy step ahead.
Roxanna Gapstur: That's great. You know, Mitch, our York City community is quite diverse across a number of attributes. And I know we were intentional about recruiting clinicians and staff of diverse backgrounds to help create an inclusive environment for our patients. Can you tell me a bit about these efforts and why you think it's an important element of the START clinic?
Dr. Mitchell Crawford: Absolutely. Thanks for asking about this intentional effort, Roxanna. The START Clinic employees 25 team members who are not only diverse in skill sets and treatment approaches, but also in race, ethnicity, gender, and languages spoken. This creates a more welcoming environment with more opportunities for our participants to identify with staff.
Furthermore, our diverse staff are trained to providing participant-centered, recovery-oriented, trauma-informed care. This positions us to serve our participants in the most comfortable way possible and helps us become a trusted partner in the community.
Roxanna Gapstur: Yeah, Mitch, I couldn't agree more. And it's our partnerships with other community organizations that really strengthen the trust we can build as an organization. I know the START Clinic is working closely with at least 14 different partners, making referrals to ensure each patient has access to an appropriate plan of care. It's really incredible.
I'd like to just list a few of the partners so that our listeners know who they are. So, first is York County Veterans Affairs Office, the rabbittransit, MidPenn Legal Services and Family First Health. But the one I'd like to explore a bit deeper with you is the partnership with the Community Action for Recovery and Diversion Project or CARD. Can you talk about that?
Dr. Mitchell Crawford: Absolutely. The collaboration with CARD is aimed at reducing incarceration rates for individuals with substance use or other behavioral health disorders by appropriately diverting from the criminal justice system to instead receive behavioral health treatment. Recognizing this need, Judge Trebilcock, who was the founding judge for CARD, described a total system failure in reference to cycles of arrest and incarceration for those who would be better served with treatment. He further described that this is a community issue, not just a justice issue.
START works closely with CARD, the Reentry Coalition, York County Probation, York County Mental Health and Intellectual and Developmental Disabilities, and York County Drug and Alcohol Commission and others towards a shared goal of diversions to treatment when appropriate. We recently received feedback from Judge Trebilcock about a program participant who was provided prompt access to treatment, that the participant had a dramatic change in sentencing. He stated, "You saved this woman from six months in jail."
Roxanna Gapstur: Wow, Mitch, I'm eager to see the outcomes of this new innovative approach in caring for patients with behavioral health and addiction needs. Treating the whole person with dignity and respect in an inclusive setting certainly seems like a recipe for success.
So thank you for being with me today. I appreciate your dedication to supporting friends and neighbors in South Central Pennsylvania in their wellness and recovery.
Dr. Mitchell Crawford: Thank you so much for this opportunity, Roxanna. It was a pleasure to talk with you.
Roxanna Gapstur: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.
Roxanna Gapstur: In this episode of Inspiring Health, we're exploring another WellSpan innovation specifically around our work to find a better way to care for vulnerable members of our community by increasing access to coordinated treatment in a certified community behavioral health clinic.
So today, we'll talk about the innovative care delivery model being used within WellSpan Philhaven's START Clinic based in the city of York. And we'll talk about how we're creating an inclusive environment for the treatment of complex and diverse patients, as well as the community partnerships that are supporting these services and how are collaborations designed to reduce incarceration rates among individuals charged with minor crimes that are really related to mental health and addiction within our communities.
Joining me today is Dr. Mitchell Crawford. Dr. Crawford is the Director of Addiction Services for WellSpan PhilHaven and he also serves as the Medical Director for the START Clinic. He provides support and creates clinical services for the treatment of addiction throughout our whole health system and has received specialized training in the treatment of substance use disorders. He's an advocate of medication-assisted treatment for patients which uses medications in combination with counseling and behavioral therapy. Dr. Crawford, thanks for being here.
Dr. Mitchell Crawford: Thank you so much, Roxanna. It's my pleasure to be here to represent our wonderful team at the START Clinic.
Roxanna Gapstur: Well, let's start out talking about WellSpan Philhaven START Clinic and how that was made possible by a 4-million federal grant, the largest grant awarded in WellSpan's history. And in my opinion, it's an honor for WellSpan to have been recognized as a worthy steward of those dollars and to be able to put our mission into action with the certified community behavioral health clinic or the START clinic.
START stands for Specialized Treatment And Recovery Team and the care delivery model that we're using in the clinic is the first of its kind here in South Central Pennsylvania. Mitch, can you share with me what makes that model so different from traditional methods of treating mental health and substance use disorders?
Dr. Mitchell Crawford: Absolutely. And thank you so much for your kind comments about the program, Roxanna. START has two overarching principles, to provide access to treatment and to stabilize acute need that our program participants may have so that they can achieve their goals. The central question is what is most important to you right now? And how can we help?
START utilizes evidence-based approaches to care such as cognitive behavioral therapy, motivational interviewing, medication-assisted treatment for substance use disorders among others. The program works as a team to help the participant with what is important to them, whether that be services we provide internally or through one of the many community organizations we collaborate with.
When we take this approach, it makes it possible for us to deliver the right care in the right place at the right time. For example, I specialize in treating addiction and, if someone came to START, who was diagnosed with a substance use disorder and I put blinders on and only saw the addiction need, I could create what I believe to be a helpful treatment plan for them. But if they were actually coming to START to ask for help with food insecurity, and I didn't understand that, I would miss an opportunity to connect with and serve that person. When we show that we care by asking what is important to the participant and work with them on that goal, it builds an alliance that can lead to the goal of whole health.
A recent real example is that one of our team members was contacted by someone who expressed anxiety about their medications not being able to be filled at a local pharmacy following discharge from the hospital. A nurse in the program was brought into the visit and helped remedy the situation. Feeling heard, the program participant then shared that they had been drinking more than they would like, so a recovery support specialist was then brought into the visit. And they were able to schedule an appointment together shortly after to work on that new goal together. Working as one, the program found a better way of meeting the needs of the participant. And lastly, I think it's important to note that this treatment approach has helped relieve stress from other parts of the system. For example, of the many participants treated, 183 of them were diverted from the emergency department that we know of.
Roxanna Gapstur: Wow, Mitch. We know it's important to treat the whole person and it sounds like we're already seeing results from our START clinic. Yet when we think about what impacts a person's health, a lot of that happens outside of our care. And we've long talked about the impact of social determinants like food and housing insecurity, which you just mentioned, and the care model that's used in the clinic helps us address these issues and others that impact the health of individuals. Is that right?
Dr. Mitchell Crawford: That's exactly right, Roxanna. When we ask what we can be helpful with, the responses we receive are often related to social determinants of health. A good example of how the program addresses this is that START partnered with the York Hospital Food Service staff to provide My Own Meals. My Own Meals provides two to three days' worth of shelf-stable meals while the team works with collaborating partners towards longer-term solutions. This program became available to START participants on June 15th.
Roxanna Gapstur: That's really amazing. Gosh, the START clinic began seeing patients remotely in December of 2020. And I think by the time we opened the doors to the physical location in early May, we'd already served 400 patients. Were you surprised by the number of patients we serve so quickly, Mitch?
Dr. Mitchell Crawford: I was impressed, but not surprised. Michele Crosson, who is the project director at START is doing a fantastic job leading a great team. We also purposely chose York as the location after review of key data points. In York, 35% of residents live below the poverty level according to US census figures. Additionally, more than 65% of residents also reported at least one day of depressive symptoms in the previous two weeks according to the York County Community Health Needs Assessment. County health rankings also show that there is a shortage of mental health providers, which is one provider for every 920 residents. The need was so great in the York community and we were eager to help our neighbors and residents finally get a healthy step ahead.
Roxanna Gapstur: That's great. You know, Mitch, our York City community is quite diverse across a number of attributes. And I know we were intentional about recruiting clinicians and staff of diverse backgrounds to help create an inclusive environment for our patients. Can you tell me a bit about these efforts and why you think it's an important element of the START clinic?
Dr. Mitchell Crawford: Absolutely. Thanks for asking about this intentional effort, Roxanna. The START Clinic employees 25 team members who are not only diverse in skill sets and treatment approaches, but also in race, ethnicity, gender, and languages spoken. This creates a more welcoming environment with more opportunities for our participants to identify with staff.
Furthermore, our diverse staff are trained to providing participant-centered, recovery-oriented, trauma-informed care. This positions us to serve our participants in the most comfortable way possible and helps us become a trusted partner in the community.
Roxanna Gapstur: Yeah, Mitch, I couldn't agree more. And it's our partnerships with other community organizations that really strengthen the trust we can build as an organization. I know the START Clinic is working closely with at least 14 different partners, making referrals to ensure each patient has access to an appropriate plan of care. It's really incredible.
I'd like to just list a few of the partners so that our listeners know who they are. So, first is York County Veterans Affairs Office, the rabbittransit, MidPenn Legal Services and Family First Health. But the one I'd like to explore a bit deeper with you is the partnership with the Community Action for Recovery and Diversion Project or CARD. Can you talk about that?
Dr. Mitchell Crawford: Absolutely. The collaboration with CARD is aimed at reducing incarceration rates for individuals with substance use or other behavioral health disorders by appropriately diverting from the criminal justice system to instead receive behavioral health treatment. Recognizing this need, Judge Trebilcock, who was the founding judge for CARD, described a total system failure in reference to cycles of arrest and incarceration for those who would be better served with treatment. He further described that this is a community issue, not just a justice issue.
START works closely with CARD, the Reentry Coalition, York County Probation, York County Mental Health and Intellectual and Developmental Disabilities, and York County Drug and Alcohol Commission and others towards a shared goal of diversions to treatment when appropriate. We recently received feedback from Judge Trebilcock about a program participant who was provided prompt access to treatment, that the participant had a dramatic change in sentencing. He stated, "You saved this woman from six months in jail."
Roxanna Gapstur: Wow, Mitch, I'm eager to see the outcomes of this new innovative approach in caring for patients with behavioral health and addiction needs. Treating the whole person with dignity and respect in an inclusive setting certainly seems like a recipe for success.
So thank you for being with me today. I appreciate your dedication to supporting friends and neighbors in South Central Pennsylvania in their wellness and recovery.
Dr. Mitchell Crawford: Thank you so much for this opportunity, Roxanna. It was a pleasure to talk with you.
Roxanna Gapstur: That's all the time we have for today. We hope you'll join us for the next episode of Inspiring Health.