No Wrong Door: Diversion center to provide clients with multiple mental health strategies

This story has been updated to reflect the following corrections:

The Nueces Center for Mental Health and Intellectual Disabilities will be funded by $4 million in American Rescue Plan funds allocated by Nueces County for construction costs. The article previously stated that the Nueces County Hospital District would pay for the project.

Funding that the Nueces County Commissioners approved in August of 2022 to expand community mental health services will go into effect May 23 when a local behavioral health clinic breaks ground on a diversion center in the city’s Six Points Neighborhood.

The Nueces Center for Mental Health and Intellectual Disabilities, which operates programs in collaboration with local law enforcement to reduce unnecessary arrests and hospitalizations of justice-involved individuals, is partnering with Nueces County to open the new center at 1630 South Brownlee Boulevard. A groundbreaking ceremony is set for 10 a.m. May 23 at that location along with the contractor, KJM Commercial Inc., doing business as the Victory Building Team and the Levy Dykema architectural firm, both based in Corpus Christi.

Slated to begin construction in 2025, the facility will provide up to 32 beds for clients to access enhanced crisis respite services with integrated on-site primary care and substance use treatment through MHID’s crisis services system, serving as a single point of drop off for law enforcement. The facility will offer 24-hour monitoring, support and engagement, plus access to psychiatric medication management and recovery-oriented programming.

Participants will receive up to 30 days of supervised treatment, 24-hour monitoring and support and engagement, plus access to psychiatric medication management and recovery-oriented programming including supportive housing, rental and utility assistance.

While not an inpatient care facility, the diversion center, funded by the Nueces County Hospital District, will enhance behavioral health programs and build the capacity of the MHIM Crisis Intervention Teams, run in collaboration with the Corpus Christi Police Department, the Nueces County Sheriff’s Office and the Nueces County District Attorney’s office with the support of the jail, hospitals and courts, to create a community-based entry point for mental health services.

CCPD’s Crisis Intervention Team, comprised of three full-time officers and 20 assisting officers, works with MHID’s Mobile Crisis Response Team to quickly respond to mental health-related calls that come in through 911 and law enforcement, providing a critical way to reroute individuals from arrest and incarceration into respite services through MHID, which connects them to substance use disorder treatment at Cenikor or ongoing outpatient treatment at the point of potential arrest.

The new diversion center’s in-house facilities will offer its three core programs of Post-Arrest Jail Diversion, Crisis Intervention and Jail-Based Competency Restoration.

The addition of supportive housing could change outcomes for individuals in Nueces County who have committed low-level crimes, including those who are homeless, by providing recovery and treatment services to help them break the cycle of arrest, jail and release back onto the streets.

“These programs were designed with the idea of being able to provide the right place at the right time, so there is no wrong door for people to go to and there are options outside of arrest and inpatient care or hospitalization,” said Mark Hendrix, deputy chief executive officer of the Nueces Center for MHID.

“Often times, hospitalization is unnecessary,” Hendrix said. “Even if a person is taken in under warrant, the majority of the time, that emergency detention warrant for behavioral health will only get them to the point of evaluation. It does not guarantee admission or treatment, so often times, even if you’re taken in under warrant, you’re not admitted to the hospital."

MHID's crisis units began with the opening of a walk-in clinic in 2021 to give clients on-demand access to a prescribing psychiatric service provider, along with case management, skills training and psychosocial rehabilitation services and other comprehensive outpatient care options. Together with pathways crisis respite, they aimed to provide short-term crisis treatment to individuals who pose a low risk of harm to themselves or others.

The crisis units built on core programs that were established through the organization's Community Collaborative Project and behavioral health model in 2018 in response to recognition by local leadership to address the needs of justice involved persons with mental illness and substance abuse issues.

MHID’s Mobile Crisis Outreach (MCOT) Outreach Team and Crisis Intervention teams have been in place since 2007, well before the implementation of behavioral health models. However, before the behavioral health model was implemented, officials could only issue a warrant for a person experiencing a mental health crisis, which typically resulted in the person winding up in a hospital or jail without addressing an underlying behavioral health or substance use issue, explained Andrea Kovarik, director of Mental Health Services at the Nueces Center for MHID.

Officers who are trained in crisis intervention can recognize behavioral health issues and call MHID to allow mental health professionals to give an assessment to evaluate whether the person can be treated in a respite unit or substance use treatment facility to receive concurrent behavioral health treatment instead of arrest, she said.

Today, the Nueces County Jail is at 80% capacity, said Nueces County sheriff J.C. Hooper, with most of the inmates convicted of felonies or violent crimes. While magistrates do a pretty good job of releasing low-level drug offenders and non-violent offenders on personal recognizance bonds, he said he sees the diversion center as a good concept for addressing the problem of repeat offenders or those who are arrested for Class B misdemeanors such as criminal trespass.

Coordination between MHID and the jail diversion coordinator at the sheriff’s office can help screen individuals to detect underlying behavioral health issues from the moment they are in jail to help MHID evaluate whether they should be placed in treatment, Hendrix added.

The jail-based competency program, administered with the county jail, sheriff’s office, and district attorney’s office, is designed to restore competency to individuals who are deemed incompetent to stand trial as a result of mental illness.

Through this program, mental health professionals give clinical treatment to restore individuals to a point where they can undergo due process and understand their constitutional rights in a much shorter span of time than they would spend in jail awaiting a state hospital bed, which, according to MHID, can take up to 196 days and another 6 to 8 months of restoration once granted a bed at a state facility.

“Jail-based competency is a great example of how having a local treatment option really changes the landscape of experience for somebody,” Hendrix said. “What we’re able to do in an average of less than 30 days takes the system (of) Texas and state hospitals years at tremendous cost.”

MHID employs what is known as a Sequential Intercept Model provided by the Texas Department of Health and Human Services Administration and the Substance Abuse and Mental Health Services Administration, with a roadmap developed for Nueces County based on input from county-wide data and information on community services, crisis services, substance use treatment services and law enforcement.

As one of 39 entities located in 254 Texas counties that HHS recognizes as a Local Mental Health Facility, MHID leverages state funding received for planning, developing policy, allocating and developing resources for mental health services within a specific geographic area of the state to implement clinical treatment approaches and expand mental and behavioral health services.

About 1,600 clients of all ages are served by MHID each month, or 10,000 people per year, Hendrix said. These include children as young as three years old to adults who seek long-term care.

The organization employs 350 staff members who range from rehabilitation technicians to licensed professional counselors and medical doctors.

The community-based model enables MHID to integrate with other community resources and support to create a community-based entry point for services, so that MHID provides a core set of services including rehabilitation and targeted case management while ensuring people access behavioral health resources through partners including the Coastal Bend Wellness Foundation, recovery support provided by South Texas Substance Abuse Recovery Services and food, housing and shelter through the Good Samaritan Rescue Mission 911.

“The biggest misconception when people think of mental health outpatient services is that all we’re doing is prescribing medications, “ Kovarik said. “What we’re really doing is an assessment every six months to evaluate their needs, which covers all domains of their life—their relationships with family, their social life, work, volunteering and education.

“It’s not just us coming and saying, ‘This is what we think you need to work on,’ but also working with that client and them helping to drive that treatment and design that treatment program for them,” she said.

More: Corpus Christi police's crisis intervention team is taking new approach to mental health

This article originally appeared on Corpus Christi Caller Times: Mental health diversion center to provide respite and outpatient care