Bridges to Care and Recovery

Program Description

Bridges to Care and Recovery (BCR) is a collaborative effort with service providers and the faith community to reduce the stigma of mental illness, strengthen natural community supports, and link individuals to behavioral health resources. The project, coordinated by Behavioral Health Network of Greater St. Louis (BHN), supports churches in North St. Louis City and County, a designated Promise Zone region with high rates of poverty, crime, unemployment, poor health outcomes and toxic stress. Recognizing that there is a cultural stigma in seeking behavioral health treatment in the African American community and a lack of knowledge regarding resources, BCR trains church pastors, First Ladies (their wives) and volunteer “Wellness Champions” to support treatment and recovery of congregants and other individuals with behavioral health concerns. A full-time Community Connector works with the Wellness Champions to identify and link individuals to services, including free counseling sessions. BCR facilitates early intervention and access to supports before behavioral health needs result in contact with law enforcement or costly acute care at hospitals. The program expanded in 2017 to screen pregnant and postpartum women for depression and link them to peer mentors and support groups as part of a community-wide effort to reduce infant mortality.

Creativity

BCR grew out of discussions that took place after the tragic death of an African-American woman with an undiagnosed mental illness while in police custody. Leaders from hospitals, the faith community, behavioral health and homeless service providers recognized an escalating crisis in which individuals with behavioral health needs ran the risk of falling between the cracks of a fragile care system. With the knowledge that churches are frequently the first refuge sought by those in crisis, the innovative response was to utilize faith-based leaders to protect against and respond to behavioral health issues. The enthusiastic response of members from more than 50 congregations of various denominations demonstrates that this is an untapped but willing population that recognizes the problems in their community and is eager to mobilize to make a difference. Use of the faith community has also facilitated the introduction of providers who had not previously served this area.

Leadership

BCR’s unique model uses a multiplier effect to facilitate community leadership. The Wellness Champions from each cohort of churches meet monthly to share information, identify additional training needs, and brainstorm to address areas of concern. Through this relationship building, members of other churches have heard about the program and requested to join the effort. BCR utilizes media in targeted areas, including the region’s African-American newspaper, to educate about mental health and disseminate program information. We are fortunate to have strong volunteer leadership from Pastor B.T. Rice, who serves on more than 20 community boards in addition to his role as senior pastor at New Horizon Christian Church; and Geraldine Smith, First Lady for New Beginning Church who encourages involvement of other First Ladies in the infant mortality reduction initiative. We also benefit from the leadership of our partners, including behavioral health and primary care providers, consumer groups and interfaith initiatives.

Sustainability

BCR was initially supported by three area hospitals, and since 2015 has been funded by Missouri Department of Mental Health. The existence of a strong infrastructure led to a two-year grant in 2017 from Missouri Foundation for Health for the infant mortality reduction initiative. While we hope that these funding sources will be sustained, the program could continue to operate without BHN or other professional support. By building capacity in volunteers in more than 50 churches, we have created an army of champions who are committed to grass roots efforts to reduce stigma and provide supports, and ensure that their churches’ health ministries include a focus on behavioral health. BCR also connects the community to existing resources, such as the region’s 24/7 Access Crisis Intervention hotline organization, which manages calls to the project hotline, and a postpartum support hospital-based MOMs Line; these linkages will continue regardless of BCR funding.

Replicability

Bridges to Care and Recovery can readily be replicated in other high-risk communities with faith-based organizations of any religion. BHN has already received inquiries about providing guidance to organizations in Kansas City who hope to set up a similar program, and we are willing to share our training curriculum, operation manuals and evidence-based practice models. A key factor in BCR’s success has been the strong relationship building with churches and service organizations, and BHN is eager to share the lessons we have learned over the past four years as we have forged these robust connections. Technical assistance for the BCR infant mortality reduction project is provided by Susan Kendig, who as a member of the Council on Patient Safety in Women’s Health Care has expressed interest in sharing the model with her national colleagues and encouraging them to implement it in their communities.

Results/Outcomes

To date, 157 volunteers have completed 20 hours of training and are certified as Wellness Champions. After receiving training, 97% of the congregations’ participants rated themselves as more knowledgeable about mental health issues and more engaged overall. There have been consistently positive findings regarding the congregations’ relationships with and knowledge of behavioral health providers post-training. Champions have made over 900 referrals to supports and services. For 1/1 -12/20/17, 106 individuals were enrolled in BCR and 83% engaged with the Community Connectors. 75% of the clients were female, 81% were African-American, and 44% were uninsured, with another 21% on Medicaid or the local health care program for low-income uninsured adults. 104 free counseling sessions were delivered. In total, 108 referrals to services were made and the most frequent referrals besides counseling were for housing and physical health services. We are just starting to track pregnancy outcomes for the infant mortality initiative.