The mission of Imagine! is to create and offer innovative supports to people of all ages with cognitive, developmental, physical, and health related needs so they may live fulfilling lives of independence and quality in their homes and communities. Imagine!’s guiding philosophy is that all individuals, regardless of ability or disability, have talents and strengths that make them vital members of their communities.
Since 1963, Imagine! has coordinated care for local people of all ages who have developmental delays or disabilities. This care is usually initiated at birth and – for those clients who are eventually diagnosed with a disability – it continues until the end of life. Some of the individuals in Imagine!'s care have mental illness in addition to their developmental disabilities. Mental Health Partners (MHP, formerly the Mental Health Center of Boulder and Broomfield Counties) is responsible for the provision of mental health services to these individuals. However, individuals living with this dual diagnosis have needs that differ significantly from those of individuals with mental illness only -- specifically, needs for enhanced engagement, rapport building, and support in processing new information -- that were difficult for MHP to meet within its usual parameters of care. In 2005, Imagine! and MHP began developing a unique, collaborative partnership to improve the delivery of mental health services to local individuals with this dual diagnosis by enhancing communication and coordination among the client, his or her psychiatrist, mental health therapist, nurse, case manager, family members, and other significant sources of support. In 2006, Imagine!'s Behavioral Health Services (IBHS) division hired three clinical professionals with the necessary specialized skill set and launched IBHS Mental Health Supports. Through this program, clients receive routine care through Imagine!, and crisis care (e.g., hospitalizations or after-hours intervention), if necessary, through MHP. The two organizations engage in ongoing dialogue to ensure that the services are integrated to provide current best-practice supports to this group of clients.
The collaboration between Imagine! and MHP is the only one of its kind in Colorado and exemplifies innovative, "out of the box" thinking. Typically, services for these two populations are funded and delivered through highly segregated systems, but this collaboration integrates the dollars from both Medicaid and local sources and the services provided by both Imagine! and MHP and marshals additional community supports -- including family members and professional caregivers such as nurses and day habilitation program staff -- to provide comprehensive mental health services based on an understanding of the whole person.Thanks to IBHS Mental Health Supports, more than 200 local individuals with this dual diagnosis currently receive expert mental health therapy without delay from a licensed professional with more than 15 years experience working with individuals with developmental disabilities. They receive timely psychiatric assessment and intervention from physicians with more than 25 years of experience and expertise in treating individuals with developmental disabilities, acquired brain injury/traumatic brain injury, and dementia. Each of these vulnerable members of the community benefits from enhanced communication between his or her psychiatrist, mental health therapist, and professional caregivers.
Imagine!'s analysis of medication data since the program began shows that each year, the number of clients whose prescription medications decreased or were discontinued exceeded (by 2.4 - 15.8%) those whose medications increased. In addition, many clients were transitioned to newer medications with fewer side effects. Further, hospital admissions have decreased by 67% since the program began, and the overall cost for inpatient hospitalization for this population within the service area has been cut in half. These trends are significant for three reasons. First, they indicate that clients have achieved greater stability as a result of the program and have required less pharmacological intervention. Second, they show that public resources are being managed more judiciously and effectively since the program began. Third, they reflect established best practices and progress toward collective goals in the field of mental health services.
Imagine! and MHP are committed to continuing and strengthening this highly successful partnership. Both organizations are dedicated to enhancing the collaboration between professional and personal caregivers and remaining on the cutting edge of evidence-based practices in the field of mental health supports in order to further improve outcomes. As funding for services for both individuals with mental illness and individuals with developmental disabilities decreases, the local population requiring both types of services is increasing. Optimal engagement of all available supports and optimal treatment regimes to facilitate the ongoing emotional stability of each client will be necessary if future financial resources are to be adequate to meet the growing need.
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