Spotlight On: Wraparound Services

(Editor’s note: Names have been changed to protect anonymity)

This team will laugh often, require respectful communication from each other, laugh again.

This is the mission of the Smith family’s Wraparound Services team. On a Monday evening, they all circle around the family’s kitchen table for a Child and Family Team Meeting. They talk and joke like they’re about to share a meal together.

They’re all here to support Ashley, the Smiths’ youngest daughter. She has battled anxiety, self-harm, disordered eating, a suicide attempt, and withdrawal from school, all within the past year. They’ve pulled up chairs, distributed paper packets, and someone tosses the first question into the mix like a beach ball:

“What’s gone well this month?”

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What are Wraparound Services?

This strengths-based and positivity-based program has been embedded within Adult & Child Health for a long time, catching some of the most severe at risk youth cases. That said, Wraparound Services are bigger than Adult & Child. It’s an internationally used model of care that embraces severely unstable kids, not letting go until they can stand on their own.

Youths ages 6 through 17 connect with this program through a multitude of referral sources: local psychiatrists, residential facilities, Department of Child Services, and any Adult & Child service line. A large majority of referrals come from A&C’s School Based service.

A&C has two Wraparound teams, one in Johnson County, one in Marion County. The Johnson County team is the exclusive provider in its area, but Marion County has three other agencies that provide Wraparound: Midtown, Aspire, and Gallahue.

But it’s never been a competition among the Marion County providers. Until recently, when Gallahue relocated, All Wraparound providers work together and collaborate out of the same 603 E. Washington St. location.

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Each A&C team has a Leader, a Lead Clinician, a group of Facilitators, and an Access Coordinator who acts as a gatekeeper, making sure potential clients meet the criteria.

Since Wraparound involves so many support sources, the providing agency constantly works with outside entities and independent providers to create the perfect social and supportive network for a family to heal.

How do Wraparound Services work?

Elaine Trepanier, Marion County Lead Clinician and Wrap Facilitator, facilitates for the Smith family. Her job is to lead and manage the entire team through the entire process. Ashley’s team consists of her mom, dad, grandmother, sister, A&C Wrap Therapist Sophie Foster, and a Habilitation Provider. This person helps her to work on skills and interact with the outside world. A Family Support and Training Provider also works with the parents and family to understand diagnoses and give parenting tips.

Elaine’s earnest admiration for this family shines through when she talks about Ashley’s case.

“She hasn’t gone to school in a year, and she just started to go again one to two days a week,” she said. “It’s brilliant. She’s got such a great, sarcastic sense of humor. I love this child.”

“The coolest thing about Wrap, I think, is that it’s all based on family voice and choice,” said Lisa Kress, Wrap Team Leader for Johnson County. This means the family gets to choose every person they work with throughout the process.

Who oversees Wraparound Services workers?

The Indiana Division of Mental Health and Addiction certifies everyone who works in Wraparound. An agency employs the facilitators, but there are many different types of independent professionals who are also certified in the Wrap process.

Those individuals earn a spot on what’s called a “pick list.” This is a reference guide for families to look through providers and pick who they think might be right for them. A facilitator can set up interviews and meetings to help them choose.

The family can switch  providers at any point, including agency people. This helps them develop the best team possible and lets the clients wield more control over their recovery. Most teams consist of a therapist, a Habilitation Provider (Hab) and a Family Support and Training provider (FST). Other important people in the youth’s life can also join the team as natural supports.

How ‘Ashley’ utilizes Wraparound Services

Ashley’s grandmother is her natural support on the team . She was the only family member Ashley allowed to stay in the room while practicing her slam poetry piece after the CFT meeting.

“That’s the thing about Wrap,” Trepanier said. “You get to be creative in ways other types of services don’t.”

Ashley attends salsa dancing lessons and Inner Beauty workshops and writes slam poetry. She has also attended yoga sessions with Elaine and Tiffany Covele, Marion County Wraparound team leader and Ashley’s habilitation provider, as part of her Plan of Care. The Wraparound Services team is essentially extended family you get to choose. It’s a path to healing you get to alter at any point.

“It’s an in-depth process,” said Lisa Kress, a team leader for Johnson County Wraparound. “(There are) Lots of meetings, lots of past info. We build on what went well, we push you outside your comfort zone, but you have a team behind you and you’re never alone. I always say, ‘If you don’t like something, we can change it … When you remind people of that, you can see that sigh of relief.”

The strength of Wraparound Services seems to be its strength-based philosophy. “We build on what’s gotten the family through tough times before,” Trepanier said.

How Wraparound Services turns negative circumstances into a positive environment

Families who come into the program are struggling. They’ve suffered a lot. But the Wraparound Services process often seems like a celebration, even during crisis. It’s almost a mindset. Families celebrate every victory. They focus on what’s going right instead of what’s going wrong. You follow your passions. Then, you discard things not meant for you.

That mindset seems to spill into the staff as well. Every facilitator or provider witnesses the dramatic changes in these families every day, and can rattle off cases with miraculous turnarounds.

In the Smiths’ dining room, Trepanier says to Ashley, “If you were trying to get into Wrap today, you would not meet the criteria,” noting how far she’s come since beginning the process in November. The entire meeting is full of a sense of buoyancy. Laughter punctuates the discussion of every new topic. Every meeting isn’t like this, but the rhythm of Wrap is a heartbeat. It’s all-at-once intimate, compassionate, and fundamentally human.

Do you want to learn more about Adult & Child Health’s Wraparound Services program? Click here or call 317-632-6140 ext. 3252 (Marion County) or 317-736-7744 ext. 5658 (Johnson County). See the brochure pictured below for Johnson County Wraparound Services info.

This is an updated version of an article that originally published March 14, 2018.

Adult & Child Partners with Jane Pauley CHC for Integrated Health

 

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Adult & Child Center is partnering with the Jane Pauley Community Health Center to provide primary care services within Adult & Child’s behavioral health offices at 8320 Madison Ave., Indianapolis. The new integrated health clinic offers a team approach to total health care for ages 13 and older. The clinic opened its doors on Tuesday, December 15, 2015.

Integrated Care is a team approach that helps individuals be their healthiest selves – mind and body – by receiving coordinated whole health services all at one location. The Jane Pauley at Adult & Child Integrated Health Clinic will provide a full range of primary care and behavioral health services to address an individual’s physical and mental health.

“We know that individuals with mental health needs are at greater risk of having co-occurring chronic physical illness,” said Allen Brown, Adult & Child CEO. “This is an opportunity for behavioral health staff to work collaboratively with primary care staff to consider how someone’s physical health may be impacting their mental health, and vice versa.”

Marc Hackett, Executive Director of The Jane Pauley Community Health Center, said, “We are committed to providing affordable, accessible, and high-quality primary care services. Our expansion of clinic sites demonstrates the community’s need for low-cost, convenient primary care. This unique behavioral health partnership with Adult and Child helps us better meet the community’s needs for total health.”

We are proud to be one of only a few partnerships in the State of Indiana to leverage the resources of a Federally Qualified Health Center, a Community Mental Health Center, and a Licensed Child Placement Agency to collectively improve the lives of people who experience physical health concerns, mental illness, addictions, and trauma.

About Adult & Child: Adult & Child is a non-profit agency with services that help people live healthier lives and reach their goals. We support people of all ages, impacting every area of life. Our behavioral health and child welfare staff partner with clients to help them set goals for mental wellness and self-sufficiency, and meet those goals.

About The Jane Pauley Community Health Center: Established in 2009, The Jane Pauley Community Health Center serves the local community, regardless of insurance or income, with an emphasis on integrating medical and behavioral health. The center also focuses on the management of chronic diseases, such as diabetes, cardiac disease and depression. They served 5,870 unique patients in 2012.

An Innovative Approach: Opening the State’s First “Tech-Enabled Behavioral Health Home”

Adult and Child has received a grant from the Division of Mental Health and Addiction (DMHA) to open a Tech-Enabled Behavioral Health Home, the first in the State of Indiana to integrate a web-based platform in their program design. People with mental illness die, on average, 25 years younger than the rest of the population, often due to unmanaged chronic disease.  This pilot program addresses the poor mental and physical health outcomes among adults experiencing a serious mental illness and gives them a single “home” for their coordinated health care services.

 

“We are excited to expand our services, and improve support for adults’ total health needs,” said Allen Brown, CEO at Adult and Child Center. “In addition to supporting our goals of improved health care for our clients, this model is of particular interest to many of our community partners because it allows for one stop health care shopping, social support engagements, supported employment, housing access, and on-going quality care. We believe this pilot will demonstrate both improved health outcomes and significant cost savings in treating people with serious mental illness.”

 

 

About the Tech-Enabled Behavioral Health Home

The Tech-Enabled Behavioral Health Home is aimed at improving all health outcomes, while decreasing the costs of care. Adults who struggle with co-occurring mental and chronic physical health conditions comprise 5% of the population, but are estimated to use 50% of the available health care funding, due to their inability to effectively manage their illnesses.

 

Research demonstrates adults who experience a serious mental illness, when left to their own devices, do not effectively manage their health (mental or physical); often resulting in early mortalities and significantly increased costs of care (increased duration and frequency of inpatient stays and increased inappropriate health care expenses).

 

The primary guiding principles of this program are based upon the idea that mental illness is treatable; and that the role of A&C staff is to guide and support consumers in their recovery. Core elements of the Behavioral Health Home Pilot include disease self-management supports, patient focused delivery system design, clinical decision support, clinical information systems, and encouraging community linkages. Tech-Enabled Behavioral Health Home services will be available to adults who reside in Marion and Johnson counties, and who experience serious mental health and co-occurring primary care disorders.

A&C offers FREE myStrength membership – the health club for your mind

Adult and Child Center is very excited to announce our partnership with myStrength to help the Greater Indianapolis community better track and self-manage their mental health. A&C has supported the mental health needs of the community since 1949 and we have long believed that education and prevention are critical aspects of mental health. This technology allows consumers, family members, and everyone else the opportunity to learn about and track your personal mental health trends in a manner which is tailored to your personal interests.

myStrength is like a personal trainer for your mental health – but FREE! And we are confident you will enjoy it.

Register here

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