TABLE OF CONTENTS
ANNUAL REPORT
Fiscal Year 2013
We Care, We Listen, We Respond… 24 hours a day
TABLE OF CONTENTS
Contents
History ____________________________________________________________________________________________________ 1
A Year In Review – Fiscal Year 2013 ____________________________________________________________________ 2
ACI Crisis Services – DMH Eastern Region of Missouri
2
St. Louis County – Youth Connection Services
2
St. Charles County – Youth Connection Services
2
Follow-up Program
3
National Suicide Prevention Lifeline (NSPL)
3
National Safe Place
3
Mental Health First Aid and ASIST Training
3
Other Services
3
Who We Are_______________________________________________________________________________________________ 4
Governance – BHR Board of Directors
4
Leadership
4
Clinical Team
4
Links with the Community
4
Community Impact _______________________________________________________________________________________ 6
Call Volume
6
Our Clients
6
Mobile Outreaches
7
How We Perform _________________________________________________________________________________________ 8
Accreditation
8
Continuous Quality Improvement
8
Satisfaction
8
Strategic Goals
10
FY 2013 Strategic Goals Evaluation
10
FY 2014 Strategic Goals
10
Contact Information _____________________________________________________________________________________11
HISTORY
History
Behavioral Health Response (BHR) is a nonprofit organization developed in 1994 by the Eastern Region
Community Mental Health Centers designated as the Administrative Agents (AAs) for the Missouri Department
of Mental Health (DMH). BHR was developed to plan, coordinate, and deliver access and crisis intervention
services. The crisis system serves all residents of DMH’s Eastern Region of Missouri and the counties of Iron,
Washington and St. Francois; some 2.2 million individuals reside in the ten-county region. Find out more
about BHR at www.BHRstl.org.
A for-profit subsidiary, BHR Worldwide (BHRW) was incorporated in 2006. With innovative approaches to
assessment, intake, crisis intervention and call handling, we provide clients many value added services. BHRW
helps increase access to client facilities, decrease expenses and improve processes. BHRW provides services to
clients as varied as community and state mental health centers, Managed Care organizations, in-patient and
out-patient substance abuse facilities, hospitals, regional and national employee assistance programs. Find out
more about BHR Worldwide at www.BHRworldwide.com.
BHR systems are designed and our staff is selected and trained to provide professional, culturally sensitive and
immediate clinical assistance. BHR provide professional clinical services twenty-four hours a day, 365 days a
year. BHR staff consists almost entirely of master’s level and above clinicians with degrees in psychology,
counseling, social work and other behavioral health disciplines.
Eastern Region Population Distribution
(Population estimates as of July 1, 2012, per US Census –www.census.gov)
County
Population
PCT
Community Mental Health Center
St. Louis
1,000,438
45.55%
BJC Behavioral Health
St. Charles
368,666
16.79%
Crider Mental Health Center
City of St. Louis
318,172
14.49%
Hopewell Center/BJC Behavioral Health
Jefferson
220,209
10.03%
COMTREA
Franklin
101,412
4.62%
Crider Mental Health Center
St. Francois
65,917
3.00%
BJC Behavioral Health
Lincoln
53,354
2.43%
Crider Mental Health Center
Warren
32,753
1.49%
Crider Mental Health Center
Washington
25,095
1.14%
BJC Behavioral Health
Iron
10,374
0.47%
BJC Behavioral Health
2,196,390
TOTAL
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A YEAR IN REVIEW – FISCAL YEAR 2013
A Year In Review – Fiscal Year 2013
ACI CRISIS SERVICES – DMH EASTERN REGION OF MISSOURI
BHR handled 47,125 inbound and outbound calls providing crisis services in the eastern region. The
components of the access/crisis intervention (ACI) system coordinated by BHR include: a professionally
staffed 24/7 telephone crisis hotline; 24/7 face-to-face evaluations in the community (Mobile Outreach
Services); follow-up and care coordination services for all individuals who receive Mobile Outreach Services;
next-day urgent appointments at the community mental health centers; a crisis-stabilization bed; and
information about and assistance with the civil involuntary detention process.
ST. LOUIS COUNTY – YOUTH CONNECTION SERVICES
BHR’s funding through the St. Louis County Children’s Service Fund to provide a dedicated Youth Connection
Helpline was significantly increased on January 1, 2013. Between July 1, 2012 and June 30, 2013 BHR handled
23,651 inbound and outbound calls on the Helpline - a 77% increase over call volume from the prior fiscal
year. BHR provided assistance to over 1,700 St. Louis County youth, which is an increase of 128% when
compared to the number of youth served prior to the Helpline in 2010. The Helpline provides assistance to
youth experiencing mental, emotional and/or behavioral symptoms and substance abuse symptoms. Services
provided included crisis intervention, referrals/linkage to community resources and face-to-face evaluations in
the community. BHR also provided texting services so that St. Louis County Youth could contact the helpline
24/7 via texting. BHR will start providing online chat crisis assistance in the 2014 Fiscal Year.
ST. CHARLES COUNTY – YOUTH CONNECTION SERVICES
BHR received continued funding through the St. Charles County Community and Children’s Resource Board
(CCRB). Between July 1, 2012 and June 30, 2013 BHR handled 5,042 inbound and outbound calls on the St.
Charles County Youth Connection Helpline which is over a 600% increase from BHR’s first year of funding. The
Helpline provided assistance to youth experiencing mental, emotional and/or behavioral symptoms and
substance abuse symptoms. Services provided included crisis intervention, referrals/linkage to community
resources and face-to-face evaluations in the community. BHR also provided texting services so that St.
Charles County Youth could contact the helpline 24/7 via texting.
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A YEAR IN REVIEW – FISCAL YEAR 2013
FOLLOW-UP PROGRAM
BHR Follow-Up Program was established in Fall 2010, with the creation of the St. Louis County Youth
Connection Helpline funded through the Children’s Service Fund and the Suicide Lifeline Crisis Helpline funded
through SAMHSA. In January 2011, BHR added another follow-up program, St. Charles County Youth
Connection helpline funded through The Community Resource Board of St. Charles County. In March 2013,
BHR crisis line began to offer follow-up calls to all callers who utilized our mobile outreach services in our 10
county regions. In Fiscal Year 2013, over 2300 cases received follow-up services. Follow-up coordinators
made nearly 14,000 outbound calls for those cases.
NATIONAL SUICIDE PREVENTION LIFELINE (NSPL)
BHR is a networked crisis center for the National Suicide Prevention Lifeline (NSPL). BHR was awarded funds
through Substance Abuse and Mental Health Services (SAMHSA) to provide follow up services for a cohort of
callers who have experienced recent suicidal ideation and agreed to participate in follow up services. BHR
handled 8,617 inbound and outbound calls though our Suicide Lifeline and SAMHSA follow-up services.
NATIONAL SAFE PLACE
BHR provides live clinician access via the National Safe Place Text for Help Program. Youth who text the
National Safe Place program are given the option to reach a live clinician via an SMS texting system. BHR
responded to requests from youth across the United States, engaging in over 360 text exchanges on via the
National Safe Place Text for Help system.
MENTAL HEALTH FIRST AID AND ASIST TRAINING
BHR provided 30 Mental Health First Aid training to agencies and organizations. Mental Health First Aid
teaches a 5-step action plan encompassing awareness, recognition, skills, resources and compassion to assist
an individual in crisis connect with appropriate professional, social, peer, and self-help care. Mental Health
First Aid training programs were primarily funded by the St. Louis County Children’s Services Fund.
BHR continued to offer Applied Suicide Intervention Skills Training (ASIST) to internal staff, mental health
center colleagues and a broad community of mental health providers, law enforcement personnel and
educators. ASIST is a comprehensive suicide intervention training program. BHR provided 3 ASIST trainings
this fiscal year and some in partnership with the Gateway Youth Suicide Prevention Resources Partnership
(GYSPRP).
OTHER SERVICES
BHR’s sophisticated technology as a 24/7 call center is continually enhanced with the expansion of and
improvements to an intranet which provides rapid access to key contract information, on-call schedules,
resource information and company policies and procedures. In addition to Eastern Region ACI services, BHR
provides crisis hotline services for the Missouri Crisis Access Response System (MOCARS) , a consortium of
Missouri DMH AAs outside of the Eastern Region. BHR provides crisis and after-hours call-center services for
two Community Mental Health Systems in Michigan and for SEARHC a non-profit tribal health consortium of
18 Native communities which serves the health interests of the Tlingit, Haida, Tsimshian, and other Native
people of Southeast Alaska.
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WHO WE ARE
Who We Are
GOVERNANCE
BHR is governed by a Board of Directors consisting of the CEOs of the founding Administrative Agents and
other key behavioral health providers. Board members are: Kim Gladstone, BJC Behavioral Health; Laura
Heebner, Crider Health Center; Mike Keller, Independence Center; Mike Morrison, Bridgeway Behavioral
Health; Wendy Orson, Amanda L. Murphy Hopewell Center; Lara Pennington, Queen of Peace; Margo Pigg,
Community Treatment, Inc (COMTREA); and Joe Yancey, Places for People. Wendy Orson served as Board Chair
during FY ’13.
BHR financial records are audited annually by an independent auditing firm for compliance with standard
accounting practices. For the ’13 audit (completed during the 2nd quarter of FY ’14) auditors approved
accounting practices and found BHR to be financially sound at year-end.
LEADERSHIP
BHR’s Executive Team is Patricia Coleman, President and CEO, Dr. Bart Andrews, Vice President of Clinical
Operations and Carisa Hill, Chief Financial Officer. Angela Tate oversees the call center and mobile outreach
services as Director of Clinical Services.
CLINICAL TEAM
BHR’s clinical team includes five clinical managers and 85 full-time and part-time employees who provide
access and crisis services telephonically and through mobile outreach evaluations. All clinicians have mentalhealth-related master’s degrees, and many are licensed to practice independently as professional counselors,
social workers, or psychologists.
LINKS WITH THE COMMUNITY
Our community involvement
BHR employs a full-time Community and Organizational Development Manager who ensures BHR is connected
and represented in the community throughout the eastern region of Missouri. BHR also has a Community
Advisory Board comprised of community members that collaborate with BHR to aid in the continued
development of the relationship with the community. BHR continues to market and promote the Youth
Connection Helpline in St. Louis County.
Crisis Intervention Team (CIT) trainings
In partnership with dozens of law enforcement agencies, National Alliance on Mental Illness (NAMI), Mental
Health America (MHA), and the mental health provider community, BHR aides in the development and
expansion of Crisis Intervention Team (CIT) in the Eastern Region and statewide. BHR has membership on the
CIT Coordinating Council, CIT Missouri Council, CIT Training Committee, and other committees devoted to CIT
and success. To date, over 3500 police officers have received CIT training to provide competent, safe,
compassionate intervention for mental health consumers and those at risk of suicide. BHR was instrumental in
the development of CIT training for officers that work with youth and in the expansion of CIT program in the
St. Louis area and surrounding regions.
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WHO WE ARE
Gateway Youth Suicide Prevention Resources Partnership (GYSPRP)
BHR is a founding member of GYSPRP. GYSPRP has been awarded Department of Mental Health funding for six
consecutive years to continue expansion of community suicide prevention and education services. The
partnership provides age-appropriate suicide prevention awareness education in schools, ASIST workshops
and Question Persuade and Refer (QPR) Training for providers, teachers, school counselors, clergy, police
officers and other gatekeepers, general and specialized crisis hotlines. An advisory committee consisting of
educators, providers, advocates and community leaders provides leadership and direction for GYSPRP.
Other community involvement
In close collaboration with the Regional Health Commission, BHR Board Members and senior executives played
key roles on workgroups and advisory boards for the Eastern Region Behavioral Healthcare Initiative (ERBHI).
BHR leadership is well-represented on the Board and working committees of the Behavioral Health Network
(BHN).
BHR’s management team serves the community in many capacities, participating in: the St. Louis County
Health Improvement Plan, The St. Louis Integrated Health Network’s Transitions of Care Task Force, the St.
Charles County Children’s Coalition, Paraquad’s Board of Directors. the Great Circle’s Regional Council,
TouchPoint Autism Service’s (now Life Skills / TouchPoint) Human Rights Board, Mental Health America of
Eastern Missouri, Missouri Coalition of Community Mental Health Centers, Workforce Investment Board – City
of St. Louis, and the St. Louis Regional Chamber.
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COMMUNITY IMPACT
Community Impact
CALL VOLUME
Call Center
Goal
Total Calls Answered
FY11
FY12
FY13
175,814
188,480
196,199
Call Abandonment Rate
5%
4.10%
5.7%
3.5%
Average Speed to Answer
15 sec
12
14
11
% of Calls Answered < 30 sec
95%
94.30%
93%
95.4%
OUR CLIENTS
Age/Gender Breakdown
Presenting Problem
Who Calls
Lethality Screening
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COMMUNITY IMPACT
Outcomes
MOBILE OUTREACHES
Outreach Age/Gender Breakdown
Outreach Totals
Outreach Outcomes
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HOW WE PERFORM
How We Perform
ACCREDITATION
BHR is accountable to a Quality and Standards Committee comprised of the Clinical Directors of its partners in
the Eastern Region ACI System, and meets the Missouri Department of Mental Health standards and regulations
for staffing, training, safety, service delivery, and, utilization reporting.
BHR invites CARF and the American Association of Suicidology (AAS), two external credentialing organizations,
to review its leadership, management and service delivery systems. CARF conducted a site examination in
August 2011 and determined that BHR was in compliance with all of its standards for Crisis and Information
Call Centers. The examiners’ report found BHR’s information technology and IT Plan to be exemplary and cited
27 organizational strengths. BHR was awarded a three year certification with no recommendations for
improvement. (Fewer than 3% of organizations reviewed by CARF receive certification without
recommendations.) BHR’s most recent AAS recertification site examination in November 2008 resulted in a
highly favorable evaluation report and full five-year accreditation. BHR’s next AAS site examination is
scheduled for October 2012.
CONTINUOUS QUALITY IMPROVEMENT
BHR executives demonstrated commitment to continuous quality improvement and support for accrediting
organizations by serving as CARF surveyors and AAS site-examiners. BHR’s CEO served as the Crisis Center
Director on the Board of Directors.
Data from virtually every aspect of service delivery, financial performance, training, employee performance and
productivity, and, internal and external customer satisfaction is monitored, measured against benchmarks and
objectives, analyzed and utilized for continuous quality improvement. Program evaluation data is reported
continuously through BHR’s monthly performance reports, monthly utilization reports, and monthly, quarterly
and annual quality summary reports.
SATISFACTION
Employees
The Employee Satisfaction survey for FY’13 was revamped from the previous surveys. The anonymous survey
focused on work satisfaction and consists of eight questions in 4 point-Likert format. It provides the
opportunity to offer general comments and comments related to each question.
Fifty-four of our employees responded. Overall aggregate Likert scores were in the “somewhat satisfied-very
satisfied” range, Employees reported a score of 3.06 I often leave work with feeling of satisfaction. Employee’s
recommendations were reviewed prioritized and an action plan was created to address concerns.
Consumers
BHR offers a telephonic consumer satisfaction surveys at the end of every call from individuals who have called
the crisis line and for whom an intake was conducted. Likert scores average in the “Very Satisfied” (8.0) range
for a series of items that tap satisfaction with promptness of response, courteousness, understanding and
compassion of counselors, referrals and respect. BHR achieved an average score of 8.56 out of 9 on an item
that assesses the likelihood that the consumer will call the crisis line again if needed.
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HOW WE PERFORM
DMH E. Region – Satisfaction
St. Louis County Youth Connection Helpline –
Satisfaction
St. Charles County Youth Connection Helpline –
Satisfaction
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HOW WE PERFORM
STRATEGIC GOALS
BHR’s companywide goals for FY ’13 were established as part of the Board of Directors’ annual strategic
planning meeting convened in April 2012. The management team reviewed the five-year strategic plan and,
with that plan in mind, set ’12 goals for three major areas of the organization. The table below presents the
goals, highlights key objectives associated with each goal, and summarizes outcomes achieved by year-end.
FY 2013 STRATEGIC GOALS EVALUATION
1.
2.
3.
BHR will increase its revenue by 10%.
BHR met this goal
BHR will increase its profit by 1%.
BHR did not meet this goal
BHR will adapt and thrive in a changing healthcare environment.
BHR continues to succeed and adapt in a rapidly-changing healthcare environment.
FY 2014 STRATEGIC GOALS
1.
2.
3.
BHR will increase its revenue by 10%.
BHR will increase its profit by 2%.
BHR will adapt and thrive in a changing healthcare environment.
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CONTACT INFORMATION
Contact Information
In Crisis?
For an emergency dial 911;
Otherwise, check www.BHRstl.org for crisis services and
phone numbers to call
Employment:
www.bhrstl.org/employment.htm
Admin Line:
1.314.469.4908
1.866.469.4908 (toll free)
Sales:
1.314.628.6235
1.866.366.5885 (toll free)
Find out more at
http://ww.BHRstl.org
Or on Facebook at
http://on.fb.me/1fiIi0i
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