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Pahoua K. Yang

Vice President, Community Mental Health and Wellness, Amherst H. Wilder Foundation

Amherst H. Wilder Foundation’s CCBHC Story

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When Cha* was brought to us at the Wilder Foundation, he was out of control and struggling with addiction. He was homeless, had no insurance, no job and no path to recovery. His parents, who were his main support, didn’t speak English.  They didn’t know much about substance use or mental health disorders, but they weren’t ready to give up on their son.

A year ago, there wasn’t much hope for a happy ending. With no team and no programs in place to help him, we would have referred Cha out just like we had many times before, and likely to an organization without the cultural and linguistic capacity to engage Cha and his entire family in his recovery in the way that is meaningful for him. But today, we’re a Certified Community Behavioral Health Clinic (CCBHC) – a new kind of provider designed to offer a comprehensive range of integrated mental health and substance use disorder services to society’s most vulnerable. And for Cha and his family there is a happy ending.

Cha was part of our first graduating cohort from Wilder Recovery Services, our new integrated substance use and mental health program. It was a joyous experience with multiple generations – parents, children and siblings of graduates, all touched by recovery. Today, Cha is living in sober housing and working on employment and the development of new skills – he is interested in how to use his experience with recovery to help others. Where he was once ostracized, he is now accepted and surrounded by a loving family and is part of a community again.

This is what it means to be a CCBHC. Medicaid ensures that we’ll be able to address previous service shortfalls by paying a rate that meets the costs of these services. Because of the CCBHC model, we can build treatment and services around what people and families need to achieve and maintain recovery rather than what they can afford. All behavioral health organizations need to operate this way.

With greater access to services, we serve more patients more quickly. Like many behavioral health clinics, we used to have a one- to two-month waitlist for therapy; the waitlist for psychiatric care was even longer. Critical culturally and linguistically specific services had a nine-month waitlist because they were offered nowhere else in the area. When you or your child needs help, it’s unreasonable to wait nine months. Now, the average wait-time for a first appointment is six-to-seven days. And anyone who needs help can get same- or next-day care. A year ago, I wouldn’t have believed it was possible.

Getting needs met in a timelier way is more than just an administrative triumph. It means more lives are touched; more lives are made better; more lives can get on the trajectory of wellness. Coordinated care means our clients can reach out to anyone on their team and know they’ll be connected to the care they need. Our organization’s mission is to improve lives today and for generations to come however we can; being a CCBHC helps us do exactly that.

But change isn’t always easy, and it’s been a significant lift for our team. It’s hard because we’re constantly building, rebuilding and refining, but at the same time, it’s exciting to be a part of something so important and potentially life changing for our providers, and for the people we serve. Before becoming a CCBHC, we didn’t have a chemical dependency/co-occurring treatment program.  It had to be built from scratch. But the biggest (and best) lift was reintroducing services that we couldn’t afford to have as a non-CCBHC; important services that complete our continuum of care like rehabilitation and skills-based services for children and adults and peer and family peer specialists.

Navigating the many changes is easier because we know that this model better fits the needs of the people we serve, and our team is better for it because they’re seeing the results daily. In addition to meeting the needs of the people who come here, we needed to do something to help our staff. The demands on them were enormous and they were burning out. Now, we work as a team. There’s permission, in fact an expectation, of collaboration and self-care. Now, there’s time to address the needs of the people we serve, as well as the needs of the people we employ.

One of our directors who is approaching retirement shared that even though our CCBHC journey has been challenging at times, she never realized at the end of her career she could be part of something so special. We all feel that way. Being a CCBHC is something special. Something revolutionary.


* Not his real name.