Since 2004, XDS, Inc., or Cross Disability Services, has served adults with psychiatric, developmental, and substance abuse disabilities in Orange, Person, Chatham, Durham, and Alamance counties. Core to their service array has been a well-respected assertive community treatment (ACT) team. An ACT team provides wrap-around treatment and support for persons with the most complex mental health needs. The multidisciplinary team includes a psychiatrist, nurse, case managers, and a peer support specialist. They may deliver medications daily or help someone find safe and affordable housing. They also teach skills for managing symptoms and finding jobs. The goal of all treatment at XDS has been to assist persons with dually existing disabilities to lead meaningful lives in the community.
The UNC Center for Excellence in Community Mental Health is based at UNC-Chapel Hill School of Medicine. Through its specialized programs, Schizophrenia Treatment and Evaluation Program (STEP) and Outreach and Support Intervention Services (OASIS), the Center provides state-of-the-
“Combining forces with XDS allows us to continue to develop evidence-based, cost-effective treatment and training models that span a continuum of care and address the changing needs of a patient whose illness lasts a lifetime,” says John Gilmore, MD and director of the Center. “I am very excited about XDS staff joining with us in this work.”
XDS leadership is energized about the merger as well. “We share the Center’s values and commitment to improving care for people living with severe mental illness,” states Thava Mahadevan, former executive director of XDS and now director of operations at the Center. “It is a pleasure to combine the vision and talents there with the skills and dedication of our staff from XDS.”
The new venture is part of the UNC School of Medicine’s critical access behavioral healthcare agency, or CABHA, the new model for mental health and substance abuse services developed by the NC Department of Health and Human Services.
A Stronger Organization
Mental health services in North Carolina continue to go through unprecedented changes. Moving forward, they will also be affected by health care reform taking place at the national level. The formal joining of the Center and XDS will create an organization with the strength and flexibility needed to thrive in uncertain times, and to continue UNC-Chapel Hill’s tradition of public service by keeping engaged scholarship active in public mental health care in North Carolina.
“We already share what works well with other communities, with legislators, and other policy makers to improve care for people with mental illness,” says Gilmore. “With the addition of XDS services and experience, we will have more to contribute to the conversation.”
Research and Training Efforts Will Grow
From a research perspective, the expanded Center will increase its ability to form new lines of study based on broader community mental health experiences to improve recovery outcomes. Likewise, it will also be able to expand its capacity to apply what is being learned in academic and scientific settings to real-life situations.
Gilmore also points to the merger as a way to significantly enhance training the next generation of community mental health providers. The Center has a long tradition of providing on-site training to psychiatry residents and graduate students from disciplines such as social work, psychology, nursing, pharmacy, and rehabilitation counseling psychology from institutions including UNC-Chapel Hill, NC State, and Duke.
The Center also trains mental health workers already in the field through coordinated efforts with NC Area Health Education Centers and local community groups. In the fall of 2010, the Center partnered with Wake County NAMI (National Alliance for the Mentally Ill) Central Regional Hospital, the NC Division of Health Services Regulation, and others, to launch Group Home Employee Skills Training Project (GHEST), a pilot training program for group home workers. Designed as an interactive, three-day program, GHEST teaches a variety of skills that direct care employees need to successfully support people with severe mental illness. Hours count towards training requirements for staff set by the state.
Clients Will Benefit
But at the end of the day, any move to change or grow services is done with the person served in mind. “We anticipate that it will be much easier for clients to transition amongst levels of care,” says Bebe Smith, LCSW, co-director of the Center. Smith goes on to say that the combined staff will be better equipped to develop flexible, long-term care models that can more easily fluctuate with an individual's needs.
“We will continue to place a focus on psychiatric treatment, but will expand into recovery-oriented areas that focus on healing through creativity,”
The new, larger Center will be able to offer a comprehensive continuum of care for the people it serves—from inpatient and outpatient services, case management, community support, and housing support, to integrated substance abuse and mental health treatment, and assertive community treatment. It will also be able to offer newly developed models of care (such as social cognition interaction therapy or computer-based cognitive remediation)
Charlene Lee, a local community member in recovery from mental illness has nothing but high hopes for the Center as it incorporates XDS services and staff into its midst. “I believe this merger will be great for the entire mental health community in our area,” says Lee. “In this unsettled time of mental health funding, lack of services, and with those living with mental illnesses seemingly being left in limbo, it is so encouraging to know that there are agencies joining forces to serve this sector of our society.”
About the UNC Center for Excellence in Community Mental Health
Founded in January 2009, the UNC Center for Excellence in Community Mental Health is part of the Department of Psychiatry at the University of North Carolina at Chapel Hill School of Medicine. Addressing quality of care and workforce development issues in North Carolina's mental health system, the Center and its programs are supported by a three-year grant from The Duke Endowment, as well as Cross Area Services Program (CASP) funds. The program operates in conjunction with multiple university, state, and community-based partners. For more information about the UNC Center for Excellence in Community Mental Health, visit unccmh.org.
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