Building a Recovery-Oriented System of Care

While NAMI St. Tammany does not hold the key to resolving mental health crisis response, our NAMI Affiliate has made great strides in building a strong, successful crisis response model in a small community north of New Orleans. A staple of NAMI St. Tammany is resilience — we have found opportunities for growth even during challenging times.

Rather than wait for changes in the system, we learn the needs of individual agencies and find a champion from within those agencies. These champions have been judges, legislators, mental health professionals, law enforcement officials, the media and family members. Then, together, we change the system from within.

Shining A Light on Our Community’s Mental Health Needs

In 2005, following Hurricane Katrina, St. Tammany Parish experienced a massive growth in population — and this migration put a strain on community resources, exhausting the almost nonexistent mental health care system. Suicide rates within the region increased and mental health care budgets were cut across the state of Louisiana.

Beginning in the 1950s, Southeast Louisiana Hospital was an essential state behavioral health hospital located in St. Tammany Parish. However, the state of Louisiana closed the facility in 2012. Local and state legislators, citizens and employees protested the closing, thrusting mental health care into the spotlight. Hundreds of patients were transported to two other long-term facilities in the state. It felt like the rug was being pulled from under an already fragile system.

Despite the devastating possibilities presented to our community, NAMI St. Tammany worked with our state representatives and local government to search for new opportunities by leveraging the needs of people living with mental health conditions in our region with available resources. Starting with the local community, one-on-one conversations eventually reached national partners.

As a result, the National Council for Behavioral Health and the Louisiana Public Health Institute completed the NAMI St. Tammany Behavioral Health Assessment, which helped identify the specific needs of the community. The assessment found that emergency rooms and law enforcement were over utilized for mental health crisis care.

As a follow-up to the assessment, we formed the St. Tammany Behavioral Health Task Force to plan how to improve the behavioral health care in our community. NAMI St. Tammany was involved in helping form and drive the task force, along with government agencies, health care providers, consumer advocacy groups and social service organizations. Our intention was to create a recovery-oriented system of care.

Building A Crisis Response Center

Through listening to experts and community members, we educated ourselves about the missing pieces in our behavioral health care system. From there, it was through building relationships that we laid the foundation to fill gaps in the continuum of care. In connecting these key elements, a collaborative change took place. NAMI St. Tammany became the convener, “the glue” that brought these systems together. This work evolved into the Safe Haven initiative, a crisis model system.

On the site where Southeast Louisiana Hospital once operated, the St. Tammany Parish Government, partnering with NAMI St. Tammany and other stakeholders, began developing the Safe Haven Campus.

Gaining the attention of funders, from local foundations to national corporations, has brought about key community programs, including the NAMI Day Center, a peer-led recovery program focused on individual and group work. The NAMI Day Center, which opened in 2017, became the first phase of the Safe Haven initiative.

The second phase, due to open soon, is the Crisis Receiving Center, which will serve as a single point of entry for people in a behavioral health crisis, diverting individuals from emergency rooms and the judicial system. At Safe Haven, individuals will be evaluated, housed up to 72 hours and ultimately routed to the most appropriate care, treatment and resources. This saves the community costly use of the emergency rooms and jail, in the most humane and effective way.

We are also building a training and education center, the first new construction on the Safe Haven Campus since the 1970s, which will house the NAMI St. Tammany offices. And lastly, a healing residential program for veterans called Cardinal Cove is currently in the early planning stages.

Diverting People from Justice System-Involvement

In 2011, NAMI St. Tammany began working closely with the 22nd Judicial District Court (JDC) to identify gaps in the criminal justice system for individuals with mental illness.

• Implementing Mental Health Courts: With volunteering judges, clinicians, attorneys and other professionals, the 22nd JDC now has five specialty courts — including the Behavioral Health Court, Adult Drug Court, Re-Entry Court, Veteran’s Court and Family Preservation Court — directly addressing behavioral health care needs and diverting people from justice-system involvement.
• Developing an Assisted Outpatient Program: Additionally, in collaboration with the 22nd JDC and the local Human Services Authority, we developed an assisted outpatient treatment program to provide community-based behavioral health treatment to individuals with serious mental illness. This program is for adults who are at risk for not living safely in the community without supervision, based on clinical assessment.
• Educating Law Enforcement on De-Escalation: As early as 2013, NAMI St. Tammany partnered with the St. Tammany Parish Sheriff’s Office (STPSO) to educate law enforcement officers on mental illness and to help inform their response when answering calls involving a behavioral health crisis. Through this initiative, 196 law enforcement officers were provided with basic mental health recognition and de-escalation skills.

To create a more effective system, representatives from the judiciary, law enforcement and NAMI St. Tammany visited cities using the evidence-based Crisis Intervention Team (CIT) Training. Through these “field trips,” the STPSO brought CIT Training to their department in 2018 and established a dedicated CIT department to our district.

NAMI St. Tammany Executive Director Nick Richard, a CIT Certified Coordinator, was awarded the Crisis Intervention Team Advocate of the Year for 2020 by CIT International. The award recognizes a family member or other community advocate who demonstrates exemplary active involvement with their CIT program. The partnership continues with the STPSO in their CIT Trainings for officers and staff.

Reaching Our Goals

There are many ways in which NAMI St. Tammany has grown into a well-recognized go-to for mental health resources. Through outreach (including radio spots, newspaper and educational TV segments, local and national discussion panels, presentations, etc.), we provide awareness about the mental health climate of the community.

At NAMI St. Tammany, we see a community need as an opportunity. Through listening, learning, educating, collaborating and relationship-building, we can establish — and reach — our goals. We can be a space that meets our community’s mental health needs.

This article was written by the NAMI St. Tammany administrative staff, under the direction of Executive Director, Nick Richard.

Note: This article was originally published in the Fall 2021 issue of the Advocate.