← Advancing Health
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- [00:01]
A
Welcome to Advancing Health. Providing effective and efficiently targeted behavioral health services to a widely diverse community is no easy task. Today we hear how a California based health system relies on accurate data collection and community partnerships to pinpoint where services are needed and how it's making a measurable difference.
- [00:28]
B
My name is Jordan Steiger and I am the AHA Director of Behavioral Health and Violence Prevention. I'm really excited to be joined today by Jesse Tamplin, who is the Executive Administrator of Behavioral Health and the Vice president of Continuous Performance Improvement and Patient Care Coordination at John Muir Health and Jamie Elmassu, who is the Director of Community Health Improvement. They've done a lot of work from community based programs to programs within their hospital system. And so we're really excited to see how they are leading the way and hopefully others can learn from the work that they've been doing. So, Jesse and Jamie, thank you so much for being here with us today.
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C
Pleasure.
- [01:03]
D
Jordan, thank you for having us to get us started.
- [01:06]
B
I would love for you to just tell the audience a little bit about your roles at John Muir Health, what you do and what your community is like and what your patients are like that you serve. Jesse, let's start with you.
- [01:17]
C
Perfect. Jesse Tamplin, the Vice President of Patient Care Coordination, Continuous Performance Improvement, and for this conversation, the Executive Administrator of Behavioral Health. I oversee all behavioral health across John Muir. And for those of you who don't know, John Muir is an independent healthcare system about 30 miles east of San Francisco. We're a three hospital system that's two acute care medical centers and then a psychiatric hospital. And then we have a large outpatient footprint with ambulatory care, including behavioral health. I work with the teams, not only the behavioral health teams, but all of the healthcare teams to really integrate behavioral health so that we can provide a whole person care model to really support our community and our patients where they're at and to make sure that they have access to life saving behavioral healthcare in our acute psychiatric hospital that serves children, adolescents, adults and older adults. One of our distinct factors about John Muir behavioral health is for our psychiatric hospital. We have some of the most under 12 and under 18 beds in California. So not only are we a local destination of care, but really a center of excellence across the whole state and many times outside of the state.
- [02:36]
B
Amazing. You said so many things I want to get back to in this conversation. And I also want to just highlight that Jesse is a member of AHA's Committee on Behavioral health and he knows his stuff in behavioral health. So he's a Great person to learn from today. Jamie, tell us a little bit about you.
- [02:51]
D
Yes. Thanks, Jordan. My name is Jamie Elmassu, and I'm the Director of Community Health Improvement at John Muir Health. My role really is focused externally mostly and primarily on the geographies that we serve, which cover and span all of Contra Costa County, Northern Alameda county, as well as the Tri Valley area. Jesse gave a little glimpse into the geography of John Muir Health. What's really important to note is that the communities that we serve are, are vastly diverse in terms of income, status, race, ethnicity, and the likes. And so when we're talking about different approaches to behavioral health and mental health strategies, it really does depend on the types of populations that we're intending to serve.
- [03:33]
B
That's great. And I think you're setting the stage really well for this first question here. So I know that your community health assessment identified behavioral health as a top priority for your community, is that right?
- [03:43]
D
That's correct. What's really unique is that I've actually been working at John muir Health for 12 years, and we conduct a community health needs assessment cycle every three years. And in my entire time that I've been here, behavioral health has been at least at the top three identified community priority needs. And so I think that's really poignant to really call out, because behavioral health, although we are innovative in our strategies and our approaches to address behavioral health needs in the community, the need still exists. Right.
- [04:14]
B
We know behavioral health doesn't discriminate, and it is present in every community and it shows up for different people in different ways. But knowing this and knowing that this has been something that has kind of shown up over and over, how did you start, like, bringing those services to the community? What was your first step?
- [04:32]
D
Yeah, I mean, so the CHNA is a really intentional approach, right? So not only is it intentional, it's also very widespread in terms of how we gather data, how we report on the data, and how decisions are being made. So it's actually a process where we collaborate with the other non for profit health systems in our area. We conduct focus groups with community members, we conduct key informant interviews with stakeholders across our service area, and we look at data. Right? So when we look at data when it comes to county resources, school district resources, and many, many others, and all of that is compiled into a really robust assessment where we actually identify those community needs, priority areas, and then we can look in and see specifically geographically or population wise, which communities are in need of services. And then when it comes back to actually creating our Implementation strategy. What we do is we actually create different approaches based on the communities that we're speaking about. Right. And it's not that John Muir Health is here designing approaches that we are now telling the community to implement. And it's actually in partnership with nonprofit organizations. And I think that's really key. And so we've created really various opportunities. Right. So whether it is, let's say, for example, a community based, non traditional approach, right. Like a promotor or community health worker approach, we have several partnerships actually, where we help fund and provide grants for those organizations to actually disseminate, you know, these very non traditional approaches to mental health interventions. And that really targets certain communities that maybe don't have access to traditional healthcare. Utilizes more of a group approach, a lay health worker approach model that's actually very effective. So we've had research studies actually done on some of our community health worker programs in partnership with Monument Impact, a local nonprofit organization. And it actually has statistically significant results in terms of reduction of anxiety, of stress and of depression in the communities that are serving. And that program specifically, we actually celebrated its 10 years, so a full decade in partnership with that program.
- [06:43]
B
I mean, congratulations on 10 years. I think 10 years in any program is incredible. And especially something that is so focused on community and, you know, driven by those community partners, I think is really something to be proud of. Jesse, I'm sure that you have played a big role alongside Jamie in helping kind of shape this behavioral health, you know, approach in the community. So tell us a little bit about what you've done.
- [07:06]
C
I work very closely with Jamie. One of the elements about a community health needs assessment, especially when you're a nonprofit, it's how are we elevating the health of the community in the local environment that we're in. And so as a hospital and a treatment providers, we also have that number one responsibility of making sure that we're providing that life saving care and that quality of care when people come into our outpatient as well as our inpatient. So it's a very nice synergistic combination where Jamie and I get together with the community stakeholders, look at our needs assessment. We have a board that oversees that community health needs assessment. And then we really look at where do we have the biggest health disparities in the community? Where do we find that we can support that community that does not have needed services, if it be in schools or unhoused, if it's for communities that are further away from a metropolitan area. So that we're really looking at Creating an ecosystem. I think one of the unique things when we talk about behavioral health is it is the most stigmatized diagnosis that we have. And as soon as you talk about behavioral health, people will go into some social aspects of behavioral health. But Jordan, as you said, behavioral health is, is regardless of socioeconomic status. The nice area that when we work with Jamie and the community health needs assessment, not only are we providing those essential services out in the community, but we're helping to stigma bust the stigma around behavioral health. So when we create this ecosystem focused on the whole person care, it's not only the individual outcomes that we're looking at, but we're helping to elevate behavioral health, decrease that stigma so people will access those services if it's in the languages that they speak or just going to seek care. And I think that's one of the big things that my partnership with Jamie really focuses on. Being operational with the community health needs assessment is ensuring that everything that we do is decreasing stigma and increasing access to life saving care.
- [09:09]
D
And if I can add some further color to that, I love what you're saying about ecosystems. And I think what we really do with our community health improvement initiatives is we go to maybe sometimes untraditional locations. Right? So for example, we are recently starting a partnership with the East Bay center for Performing Arts. Some people might say, okay, why are you partnering with an arts center? This is an arts youth center based in Richmond, California. And my answer is because the need is high. And what are we doing? We're actually helping them build their infrastructure to create more on site, licensed clinical social workers so that all of the children that are accessing the services at the East Bay center for Performing Arts, they actually have with embedded within their programming, access, direct access to these social services. And I think just by, you know, helping shape that model at a center like this in a high need area, that's really what we're talking about when it comes to ecosystem. And then secondarily, you know, it's other sites. So for example, we're deeply invested in the city of Antioch, that's in Contra Costa county as well. There are reported, you know, high rates of violence in Antioch. So what we've actually invested in is actually hiring and helping support mental health therapists. These are licensed therapists to be on site at the schools in the Antioch Unified School District. And then in partnership with other health systems, they've actually helped support, you know, wellness rooms and trauma informed specialists that are also on site in the school district for the year. So it's really around shaping that ecosystem, whether it's at the school level, at the hospital level, with the nonprofit organizations and how we do it, how do we adjust? How do we actually ask our partnerships and ask the collaboratives that we work with, what iterations do we need to actually meet the needs of the community?
- [10:56]
B
You're both bringing up so many important things with this topic. So I think, Jesse, I mean, bringing up the topic of stigma, I feel like you can't talk about behavioral health without talking about stigma. And I think, Jamie, some of those examples that you just provided really purposefully, or maybe not even, you know, purposefully decrease stigma in so many ways. When you're just in the community, you are just there and you are part of it. And it's, you know, people can get the care that they need without having to go see a provider. It's where they need it and when they need it. And I think that is so key. And one thing you both have talked a lot about is just these partnerships that you have internally, it sounds like across your system. And then of course, in the community, how did you get buy in for those partnerships, especially with the community partners?
- [11:40]
D
Gosh, how do we get buy in? I think it's a long history, right? It's a long history of relationship building and really gaining trust with community partners. I'd like to say that our partnership model with nonprofit organizations in our area is very strong. And it's because we listen. So we have a grant making portfolio. So we are providing grant funding to nonprofit organizations, but it doesn't stop there. And I think that's really what sets John Muir Health apart from other health systems really, is that our partnerships with nonprofit organizations, we also provide many in kind services, where, for example, we'll bring our family medicine residents to nonprofit organizations on site to offer some sort of an intervention, whether it's health education or foot screenings or ask a doctor stations, things like that. We've gone to Mental Health Connections, which is previously known as Putnam Clubhouse. But we've had this very robust partnership with Mental Health Connections over the years. And our family residents, they actually circulate there and they provide health education lectures to the clients of Mental Health Connections about medication management, sleep hygiene, any topics of interest to the client base at the organization.
- [12:53]
C
Jamie does an incredible job and creating those external partnerships and she has that grant making portfolio. So she's able to fund many services which can help align those, you know, partnerships. But, you know, having John Muir be a nonprofit healthcare system, we spend a lot of time with our Operational leaders and our clinicians joining community groups. So I'll give you an example. We have people on the Concord Chamber of Commerce, we work with our fire departments, we work with our school districts, part of the California Hospital association, you know, working in the Tri Valley region where Jamie was discussing making sure that if there's grants coming on, we're supporting that grant award process for other organizations, their community needs assessment. And I think that's critical when you look at behavioral health operational leaders, because stigma is reduced when people see not only people who have mental health challenges speak up and, you know, do something different, but also people who are leading those services, taking their time to work with the chief of police. So many times, both at Walnut Creek and Concord, two local cities, they've held their staff meetings and our outpatient behavioral health before so that they can see our clinicians get to know them. And that's where we really look at decreasing the stigma. And when you look at what are the results of stigma in the United States, we know people with a serious mental illness are dying 25 years younger than the average population, but they're not doing to their dying to their mental illness. This is where the stigma comes in. They're dying due to cardiovascular disease, obesity and diabetes. And as a nonprofit health system, we are perfectly positioned to be able to treat those conditions because it's part of that whole person care model that we know if we can get them into access their mental health conditions and we can stabilize that life trait, that life saving treatment, we then can get them to primary care in other groups where we can give back years of life and quality of life.
- [14:58]
B
That makes so much sense, Jesse. And I mean I hear from both of you, I think just kind of key takeaways from this discussion. It sounds like using that positionality in your community as an anchor institution and you know, a leader in the community to make sure that we are doing what we can as hospitals and health systems to decrease that stigma, to, you know, extend the hand first and get, you know, get those partnerships moving. Really listen to the community and what they need. It sounds like you are doing all the right things and you are setting such a great example. Thank you so much both of you for being here today. And I'm sure our listeners are going to have a lot of takeaways that they can start thinking about at their own organization. So again, thank you for being here.
- [15:43]
A
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts.