The Adult Access Program provides support to adults with emergent and urgent needs through brief treatment, stabilization and referrals to area providers. This program assists in implementing services for clients through collaborative efforts within the mental health system. Adult Access is an Intensive Care Services (ICS) program that started in 2012 after hurricane Irene flooded the state hospital in Waterbury. This program, among others, was created to alleviate pressures within the mental health system after the flood. A primary goal of the program is to connect clients with the community treatment system in order to divert them from psychiatric hospitalization when appropriate.
Adult Access was designed specifically to provide services to individuals in need of immediate therapeutic case management and clinical services. Referrals primarily come from the Emergency Screeners and Outpatient Program at WCMHS, as well as community partners, such as Central Vermont Medical Center, housing services and the homeless shelter, Good Samaritan Haven. Adult Access is a community or office based service with the primary goal of crisis stabilization and needs assessment. This program was templated from the Children’s Access program that has been part of WCMHS/ICS for more than 20 years.
In this last year Adult Access has also partnered with Good Samaritan Haven to hire a clinician who works specifically with guests at the shelter. This new clinician also works as a consultant to shelter staff, so that best practice protocols can be utilized in order to effectively engage guests who might have had negative experiences with mental health services in the past but need therapeutic support. Thus far this partnership has seen great success in engagement of individuals who have complex needs but would not ordinarily reach out for mental health support.
This program consists of a clinical supervisor and three full time master level clinicians. Through their collaborative efforts within the human services system clients are referred and connected to the services that will most help them move towards stability. If services are needed beyond Adult Access, referrals are made to long-term service programs, such as Community Developmental Services (CDS), Community Support Program (CSP) or the Center for Counseling and Psychological Services (CCPS). The following example provides a scenario of how Adult Access helped an individual in crisis.
This client was referred to Adult Access by his son’s CYFS case manager who was nearing the end of his involvement with the child. The father/client is an adult homeless male who had undiagnosed cognitive difficulties. He has co-occurring mental health and substance use problems and he has experienced extensive loss from numerous deaths of family members in the past three years. He has three children. He has a significant family trauma history and was in foster care as a child. He has no transportation and he has Department of Corrections (DOC) involvement. Due to his trauma he struggles to be in group settings; therefore the shelter was not an option and he chose to sleep outside instead. The client is a hard worker finding odd jobs when able.
In an attempt to gain trust the Adult Access clinician met him a number of times in his community outside at a local gas station. During this time he lost his children to Department of Children and Families (DCF) custody, which pushed him into a deeper depression and he felt that nothing had been good his entire life. After many months of building trust with the clinician through community based informal meetings he began to feel some connection and hope. With this support and his will, he was able to pick himself up from his despair and eventually weaned off the maintenance program for substance use issues. During all of this, he worked hard to make all his visits with his children. With the support of the CCPS case manager with whom the clinician had connected, he applied for Supplemental Security Income (SSI) assistance. Additionally, the client was referred and assessed for CDS, but was not found eligible.
His homelessness and lack of income continued to be a barrier to getting his children back in his custody; therefore he was continually teetering on the brink of relapse. Through partnered efforts with housing services and the Department of Mental Health he was given a housing voucher, which gave immediate stability. He eventually relinquished this voucher when he went to live with his children under the care of family members. Happily, he continues to remain sober and will be out of the DOC system in a few short months. He has not accessed the hospital or needed additional substance abuse services since his intake in 2015.
This is one of many examples of what clients may experience while working in this program. Although most clients receive short term stabilization treatment, some clients, as the example shows, are seen longer because they have complex needs but don’t fit criteria for longer term care. Although challenging, this work is rewarding when through the work clients experiencing very difficult times can shift to more stable circumstances.