Examining the Impact of Certified Community Behavioral Health Clinics on Access and Engagement in Services Among People with Severe Mental Illnesses

Background

Certified Community Behavioral Health Clinics (CCBHCs) are a federal initiative to enhance the capacity of community mental health clinics to engage and care for people with mental health and substance use disorders. Although community mental health clinics serve an array of populations, treating people with severe mental illnesses is a central part of their mission. CCBHC provides enhanced and prospective funding for clinics that deliver a comprehensive range of mental health and substance abuse services, including crisis management, assessment and planning, outpatient mental health, case management, and peer support. The CCBHC demonstration program was initially launched in eight states and established 66 CCHBCs. This study examines the impact of CCBHC implementation on access and engagement in care among people with severe mental illnesses in a large mid-Western community mental health clinic.

Method

This study conducted a secondary data analysis of the clinic’s service delivery in 2017 (pre-CCBHC implementation) and 2019 (post-CCBHC implementation). Data was selected documenting the delivery of individual therapy, group counseling, peer support, psychosocial rehabilitation, targeted case management, and assertive community treatment, which are services utilized by people with severe mental illnesses and targeted by the CCBHC program. Fisher’s exact test was conducted to examine whether the CCBHC implementation changed the number of people with SMI receiving mental health services overall and for each service. Linear regression analysis was conducted to measure whether the CCBHC implementation changed the overall average number of mental health visits per individual and for each service.

Results

In 2019, 3373 clients with severe mental illness received CCBHC outpatient mental health services, significantly more than 3561 clients in 2017 (p = 0.00). When examining each type of mental health service, Fisher’s exact tests demonstrated a significant increase in the number of people with SMI receiving individual therapy (p = 0.00), group counseling (p = 0.00), peer support (p = 0.00), psychosocial rehabilitation (p = 0.00), targeted case management (p = 0.00), and assertive community treatment (p = 0.00). Linear regression results indicated when controlling for gender and being African American, clients with SMI, on average, received 0.77 more individual therapy visits (p<0.05) and 0.42 more group counseling visits (p<0.05). There was no significant increase in peer support, psychosocial rehabilitation, targeted case management, and assertive community treatment visits.

Conclusion:

The study found that the CCBHC implementation increased access to services for people with severe mental illnesses for all services and more engagement in individual therapy and group counseling visits. This finding indicates that implementing CCBHCs is an effective strategy in addressing the problem of people with SMI not receiving mental health care. More research is needed to examine whether more access to care leads to improved clinical outcomes.