August 23, 2014
In Texas, practitioners and government staff working in the mental health system and law enforcement were seeing individuals and families repeatedly cycle through with substance abuse problems, mental health issues, and law enforcement involvement. Leon Evans, director of the community mental health system for Bexar County, Texas, encompassing San Antonio joined with other leaders to create an integrated system in the county involving a comprehensive protocol and plan for cooperative effort by a number of agencies to improve these issues applying a data-focused, coordinated approach to recovery and healing. Statistics are showing significant success, including lowered prison populations, demonstrated and lasting recovery from substance abuse problems, and improvement in functioning and health for those with mental health diagnoses.
A significant component of the effort involves the Center for Health Care Services in San Antonio. The Center is operating pursuant to the agreements and directives of the Quality Management Plan which can be viewed at this link. Center for Health Care Services, San Antonio, TX, Quality Management Plan.
It is impressive that the plan includes behavioral health and substance abuse treatment interventions coordinated among agencies, as well as early childhood intervention programs, event for infants and toddlers. It is a well-thought out thoroughly coordinated effort applying evidence-based practices to a complex problem, as to which leaders in Bexar County seem to have deep insight and understanding.
This coordinated approach should serve as a model to other states and counties. Bexar County is demonstrating that rather than applying limited services and punishments to the same individuals in a piecemeal fashion, it is more logical and effective to view troubled individuals and families in an integrated manner, to improve communication and planning among agencies, and to coordinate efforts with a comprehensive plan designed to address the whole individual. It is also important the the plan is based on recent research demonstrating that an individual’s behaviors and problems do not exist in isolation but in fact develop in the context of intergenerational problematic behaviors in families that affect the entire individual. In addition, this should serve as a model approach because it involves proactively taking control of a complex problem rather than defensively reacting to problems as they come up in a fragmented, punitive fashion, which is shown to be ineffective.