In Home Outreach Team North (IHOT) Description of IHOT North - - PowerPoint PPT Presentation

In Home Outreach Team North (IHOT)

Description of IHOT North

• Short-term intervention designed to provide in-home outreach

and engagement services to individuals with behavioral health challenges and their family members.

• Link participants with outpatient mental health services,

community resources, avoid unnecessary hospitalizations and/or interaction with the criminal justice system and reduce the effects of untreated mental illness. Relationship building is the “key” to successful linkage.

IHOT Composition

• Three agency collaboration made up of:

– Mental Health Systems (MHS) – National Alliance of Mental Illness (NAMI) – Union of Pan Asian Communities (UPAC)

• Teams consists of:

– Peer Support Specialist – Family Specialist – Case Manager

• Support Staff:

– Lead Clinician – Consulting Psychiatrist

Eligibility Criteria for IHOT

Eligibility Criteria

• Adult individuals, 18 years and older, residing in San Diego
• County. Family may live out of region.
• Identified person has serious mental health symptoms that

contribute to functional impairment in activities of daily living, social relations and/or ability to sustain housing.

• Declines mental health services, may have sporadic contact

with an outpatient mental health program, but has discontinued recommended treatment.

Eligibility Criteria Cont…

• Identified person had one, or more, of the following events in the

past year: – Psychiatric hospitalization – Psychiatric Emergency Room visit – Police/PERT involvement – Incarceration

IHOT North Coverage Area

IHOT North Coverage Areas

North Central

92037 La Jolla/Torrey Pines 92093 La Jolla East 92106 Point Loma 92107 Ocean Beach 92108 Mission Valley 92109 Pacific Beach 92110 Midway District/Linda Vista 92111 Linda Vista 92117 Clairemont 92119 San Carlos/Navajo 92120 Grantville/Del Cerro 92121 Sorrento Valley 92122 University City 92123 Serra Mesa 92124 Tierrasanta 92126 Mira Mesa 92130 Carmel Valley 92131 Scripps Ranch 92140 Marine Corp Recruit Depot 92145 MCAS Miramar 92161 UCSD/La Jolla

North Inland

92003 Bonsall 92004 Borrego Springs 92025 Escondido South 92026 Escondido North 92027 Escondido East 92028 Fallbrook/Rainbow 92029 Escondido West 92036 Julian 92059 Pala 92060 Palomar 92061 Pauma Valley 92064 Poway 92065 Ramona 92066 Ranchita 92069 San Marcos 92078 San Marcos 92096 San Marcos 92070 Santa Ysabel 92082 Valley Center 92086 Warner Springs 92127 Rancho Bernardo West 92128 Rancho Bernardo 92129 Rancho Penasquitos 92259 Ocotillo 92536 Agunda

North Coastal

92007 Cardiff by the Sea 92008 Carlsbad North 92009 La Costa 92010 Carlsbad East 92011 Carlsbad South/La Costa 92014 Del Mar 92024 Encinitas 92054 Oceanside 92055 Camp Pendleton 92056 Oceanside 92057 Oceanside 92058 Oceanside/Camp Pendleton South 92067 Rancho Santa Fe 92091 Rancho Santa Fe 92075 Solana Beach 92081 Vista South 92083 Vista Central 92084 Vista North 92672 San Clemente

Stages

• Referral
• Accepted into the IHOT program
• Outreach
• Engagement
• Short term intensive case management

– Needs assessment – Service planning and coordination – Individual and family goal planning – Referrals and linkage to community resources, benefits and entitlements

Referrals

• This is the entry

point into the program, the referral is received, further information gathered and referred individual is assessed for eligibility.

• Family member or loved ones
• Law Enforcement
• Jail System
• Las Colinas Detention Center
• Behavioral Health Units
• Hospital Emergency Departments
• Mental Health Programs
• Adult Protective Services / Senior

Teams

• NAMI or other advocacy agencies
• Optum Access and Crisis Line

Accepted & Outreach

• Accepted – Individual has been determined

to meet eligibility criteria.

• Outreach - Services begin to family (if

involved) and initial attempts are made to engage individual.

Engagement

• Individual agrees to participate in IHOT services

– Successful outcomes of IHOT participants and their families include:

• Accessing and maintaining behavioral health treatment
• Obtaining safe and stable housing
• Obtaining employment assistance, medical care and benefits
• Enhanced boundary and limit setting
• Reconnecting with family or social supports
• Improved family communication skills
• Connecting to family support services (i.e. NAMI)
• Enhanced knowledge and ability to access emergency services

Whole Person Approach

• IHOT is based on a whole person approach which

recognizes that physical, mental and spiritual health are interconnected, and recovery involves the whole person.

• Alongside the participant, the team coordinates

participant’s care, including a primary care provider.

Whole Person Cont…

• IHOT teams also assist in identifying alternative

treatment options, if medication is not the chosen method of treatment.

– Acupuncture – Natural healing – Spiritual healing – Art therapies – Other options dependent on beliefs and desires of the participant

Psycho-education

• Clinical staff will lead medication groups and provide self-care

education.

– psychiatric symptoms – treatment interventions – techniques for relaxation and management of symptoms – medication management strategies.

• Case Managers will lead resource groups.
• Upcoming… “Meet the Dr.” group that will meet monthly and be

at different locations throughout the county.

Psycho-education

• Peer Specialist facilitate monthly Peer lead support groups.
• Family Specialist run a bi-weekly family support group in English

and Spanish.

• Upcoming… Peer Specialist will be trained to provide weekly

WRAP classes for participants.

Goals of Service Delivery

• Participants and family members receive education about

mental illness, recovery, and accessing services and resources.

• Participants receive a substance abuse assessment during in-

home outreach.

• Participants receive an assessment of domestic violence issues

during in-home outreach.

• Participants shall be screened to determine the need for referral

to a primary care physician and referred for services when appropriate.

Goals of Service Delivery

• 50% of family members will be linked the NAMI F2F class.
• 80% of family members will be able to identify one or more

coping mechanisms learned through the education provided.

• 75% of participants who complete enrollment phase will

experience greater satisfaction with life than at the beginning of services.

Contact Information

Phone: 760-591-0100 Fax: 760-591-0101 Location: 365 Rancho Santa Fe, San Marcos 92078

Office Hours 7am-7pm (everyday) 24 hour phone line