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 Inland North Coastal North Central 92003 Bonsall 92004 Borrego Springs 92037 La Jolla/Torrey Pines 92007 Cardiff by the Sea 92025 Escondido South 92093 La Jolla East 92008 Carlsbad North 92026 Escondido North 92106 Point Loma 92009 La Costa 92027 Escondido East 92107 Ocean Beach 92010 Carlsbad East 92028 Fallbrook/Rainbow 92108 Mission Valley 92029 Escondido West 92011 Carlsbad South/La Costa 92109 Pacific Beach 92036 Julian 92014 Del Mar 92059 Pala 92110 Midway District/Linda Vista 92024 Encinitas 92060 Palomar 92054 Oceanside 92111 Linda Vista 92061 Pauma Valley 92117 Clairemont 92055 Camp Pendleton 92064 Poway 92065 Ramona 92119 San Carlos/Navajo 92056 Oceanside 92066 Ranchita 92120 Grantville/Del Cerro 92057 Oceanside 92069 San Marcos 92121 Sorrento Valley Oceanside/Camp Pendleton 92078 San Marcos 92058 92122 University City South 92096 San Marcos 92123 Serra Mesa 92067 Rancho Santa Fe 92070 Santa Ysabel 92124 Tierrasanta 92082 Valley Center 92091 Rancho Santa Fe 92126 Mira Mesa 92086 Warner Springs 92075 Solana Beach 92130 Carmel Valley 92127 Rancho Bernardo West 92081 Vista South 92131 Scripps Ranch 92128 Rancho Bernardo 92083 Vista Central 92140 Marine Corp Recruit Depot 92129 Rancho Penasquitos 92145 MCAS Miramar 92084 Vista North 92259 Ocotillo 92161 UCSD/La Jolla 92536 Agunda 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 Family member or loved ones • Law Enforcement point into the • Jail System • Las Colinas Detention Center program, the referral • Behavioral Health Units is received, further • Hospital Emergency Departments • information gathered Mental Health Programs • Adult Protective Services / Senior and referred Teams • NAMI or other advocacy agencies individual is • Optum Access and Crisis Line assessed for eligibility.
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
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