RHC: Sisters of Providence Health System

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Since joining Brightside in 1994, the School Street Counseling Institute has embodied this mission by operating one of the largest multicultural outpatient mental health clinics in the Pioneer Valley. A shortage of bilingual and bicultural professionals in the area places many newly arrived immigrants and English language limited residents at risk of not receiving appropriate services. With its multilingual professional staff, School Street is able to provide the highest quality psychotherapeutic services to over 2,000 children, families and elders each year. The majority of clients reside in the greater Springfield area (75%), with significant numbers from the surrounding communities of Holyoke (15%) and Chicopee (10%). Many of School Street's clients do not speak English and have experienced multiple challenges in accessing needed services in the community, advocating for themselves, and performing routine tasks, such as completing job applications. Special attention is given to the psychiatric/counseling needs of the Puerto Rican/Latino community, the largest minority group in the area, as well as to the rapidly expanding Russian community in Springfield and Westfield. Approximately 65% of clients are children/adolescents who receive individual and family treatment. Many of the children have experienced and/or witnessed abuse. Of the adult clients, at least 40% experienced abuse as children and are now in treatment with a variety of presenting problems and diagnoses, i.e. post traumatic stress, depression, anxiety. About 15-20% of clients suffer from a serious and persistent mental illness.

Implementation
The services at School Street are community-based, and are offered in a location close to Puerto Rican, African American, Russian, Italian and other multiethnic neighborhoods. Outreach services are also provided in the home for patients with specific conditions that limit their capacity to come to the clinic. In order to meet the diverse needs of the target population, services are provided in seven languages, with special attention to the cultural needs of the various groups that are served. School Street works with clients on various levels: direct clinical interventions, medication management, case management, client advocacy and support. Services include all methods of psychotherapeutic interventions, psychopharmacotherapy for patients of all ages, psychological and neuropsychological testing and mental health consultations for different referral sources, especially within SPHS. Staff frequently become advocates for clients in maneuvering complex education, legal, and public assistance systems.

School Street and the other programs within SPBHC are the largest employers of bilingual and bilingual/bicultural professional psychiatric staff in the area, and SPBHC is the regional leader in the field of multicultural and Latino Mental Health/Substance Abuse. SPBHC staff include one of only two Board Certified Bilingual Child and Adolescent psychiatrists in the western part of the state and one of the few African American Board Certified Psychiatrists, specializing in care of the elderly. As a result, other local agencies often rely on SPBHC and School Street to address staff training needs and for consultation when dealing with multicultural mental health issues and substance abuse. The School Street Counseling Institute’s staff of 25 full-time professionals encompasses a wide range of disciplines, including psychiatry, psychiatric nursing, psychology and neuropsychology, social work, counseling and counseling psychology, expressive arts therapy, and group therapy and psychodrama.

Consistent with its leadership role in ensuring access to multicultural services, School Street has also developed an effective training program aimed at enhancing the level of professional/clinical performance of clinicians (especially linguistic minorities) seeking advanced degrees in one of the mental health disciplines. The training program is geared to those who are interested in developing specialized skills for work in multicultural clinical and community settings. In fact, School Street has the only multiculturally focused pre-doctoral clinical psychology internship program in New England. It also offers a variety of practica and internships in psychology and social work in collaboration with Smith College, Springfield College, and the University of Massachusetts.

Time Frame

School Street Counseling Institute was established in 1994. Clients receive outpatient treatment services for varying lengths of time, based on the severity of symptoms. The average length of treatment is one to two years.

Financial Profile

The budget for School Street was $1.8 million in 1998 with revenues of $1.9 million projected in 1999. The majority of clients are Medicaid eligible, with the largest payer being the Massachusetts Behavioral Health Partnership.

Outcome

Key treatment outcomes are:

• Improvement in mental health symptomology and functioning
• Individual client empowerment to address social, community and health issues
• Improved family functioning with reduction in violence, physical and sexual abuse, substance abuse
• Support for educational and vocational training.

To better measure these outcomes, School Street is implementing the Access Measurement System, a tool to measure treatment effectiveness and client satisfaction. The Director of School Street is currently involved in the translation of the instrument into Spanish, with the inclusion of other languages also anticipated.