Doing Whatever It Takes

A Closer Look at Full Services Partnerships at Wilshire Community Services

Throughout this pandemic, our collective experience of challenging times has been felt across our community in ways that we have never experienced before. Our expanding capacity for empathy and kindness towards all individuals is something we will take away as one silver linings of this time.

A lot of necessary progress has been made to deepen our cultural understanding of the pervasive effects times like these have on our mental health, but many might not know that services that support individuals with severe mental illness in the community have existed all along, or they might not have presented with the opportunity to learn more about them.

We sat down to talk with Caitlin Baumhefner, LMFT, one of our Behavioral Health Clinicians at Wilshire Community Services, to hear more about our Full Service Partnership program, in partnership with SLO County Mental Health, and how it has evolved over the course of the pandemic.

Tell us a bit about yourself. How did you end up at Wilshire?

I first started working with people with severe mental illness right out of college. Through my experiences, I learned that I really enjoyed the work and learning about the different illnesses- it’s really fascinating how the mind works to me and it was rewarding to see people succeed. Some of these illnesses can be very debilitating and affect everyday functioning so helping people to manage their mental health and work through their struggles so that they can be more successful in life is awesome. Pretty much all my professional experience has been in working with individuals with severe mental illness in one way or another.

Can you tell us more about our Full Service Partnership program?

The intention of the Full Service Partnership (FSP) program is for us to provide intensive therapy, case management, medication management, and psychiatric services for seniors in our community with severe and persistent mental illness. Wilshire’s FSP program is a part of SLO County Mental Health and is specific to older adults ages 60 years old and older. Our clients receive monthly appointments with our psychiatrist to support them with the challenge of finding the right medication(s) that work for their individual needs and symptoms. In addition to medication management, we support our clients in accessing medications, learning about their medications, and coordinating medical and psychiatric care when necessary. Our team is relatively small with four and half full time employees, plus a psychiatrist and other doctors, and currently managing twenty one clients.

FSP functions as a “whatever it takes” sort of model, so it can be hard to pinpoint exactly what it is we do because it depends on the client, their needs, and what their goals are. We’ll typically see or speak to our clients four or five times a week and we try to be a short term program- to help the client meet their goal. Usually, their goals are related to some form of housing stability and or mental stability. We support getting them to a place where they can be independent and live in the community.

How does someone typically get admitted to FSP?

Clients only get admitted to us via SLO County referral. The individual must be open to receiving county mental health services, and the referral is made by either the Psychiatric Health Facility (PHF) psychiatrist or a referral from their treatment team. We are unable take outside referrals, so it’s all processed through the county. County Mental Health is there to provide behavioral health services to those that are low income, Medical recipients, or generally people who don’t have access to mental health through their own insurance or who can’t pay for healthcare. The access line, a direct line to the clinic, is where a potential client would go through a series of questioning to determine what level of care they need or help them figure out what their own insurance would cover their mental health needs. FSP is really based on severity and level of need that cannot realistically be maintained through a therapy office.

What kind support do our clients receive?

As a therapist, I’ll do therapy with my clients while simultaneously case management is linking them to community resources, skill building, individual learning skills such as how to make doctor appointments, how to keep track of doctor appointments, how to call and arrange transportation. We support them in building a wide variety of life skills, but what those are depends on the person and what their goals are. Everyone has different goals they are working towards. Sometimes we are also helping them to find housing for chronically homeless clients. Especially now with COVID-19 we are focusing on a lot of emotional support to help with the social isolation people are experiencing – the anxiety and fear about the pandemic – people really benefit from having someone to talk to, not only like a skilled therapist, but in general. More contact with people in general can be helpful.

What is the typical process for when clients are ready to transition out of FSP?

Transition from our program happens when the client has met their treatment goal or goals- whatever we’re specially trying to work towards in our program. We often come into the lives of clients when they have experienced a significant trigger or life event that is really challenging for them. Sometimes it’s becoming more emotionally stable in managing their mental health so that they can take care of other aspects of their life. Our program aims to support our clients to find appropriate housing while also managing their mental health challenges that were limiting them from being able to really live daily life. When they feel more comfortable and stable and able reach out to other community services and friends, you can really see the confidence building and the changes in people when they need less support from us. It’s truly a continual process, it’s not just like “oh they’re housed and done.”

Our society’s understanding of mental health has evolved and perception of these services and who they aim to support has improved. Is there anything that you care to share that you’ve witnessed pertaining to how a decrease in stigma has improved access?

There of course still is a stigma, but it has become more of a norm for people to talk about needing or receiving help. I think when it comes to severely mentally ill there is more stigma than there is with others, but I think especially right now with the pandemic, there has been a push recently to normalize how challenging COVID-19 has been for people and encouraging people to access the support that they need. Isolating in your home is not easy. Logging onto Zoom to connect with other people is great but it is not a direct replacement of being near people. It has been great to see a push for people to really reach out and access resources that are available to them. There are a lot of helpful options that exist out there, not just therapy: there are friendship lines, online support groups, and all sorts of programs out there to help get people more connected despite being at home by themselves, reminding them that they are not alone in this.

How has the FSP program transition or evolved since COVID-19?

Groups and peer support meetings haven’t been able to happen yet- they are one of the aspects of the program our clients are missing right now. We still provide the “whatever-it-takes” level of services but trying to shift as much as we can with safety in mind. Right now, I’m doing a lot of telehealth and technology. Technology is not something a lot of our clients feel comfortable with so then we usually communicate over the phone, but when needed, we will go to their homes and help transport them to and from their doctor appointments. Our clients have taken more of an advantage on the community support services that are out there, and some of our clients have surprised us, and themselves too, with how well they were able to manage without as frequent face-to-face visits.

We model being safe for clients as best we can, but it’s been a struggle for a lot of people to follow safety guidelines. We do our best to meet outside the home, but it can be tricky to balance safety and privacy to try to help the clients. Masks are hard for people in general and some of our clients have different reactions and fears. I wear a face shield over my mask when I see clients, which feels confining and awkward to me and I can only imagine what it looks like for the client who is also trying to read me. It’s been an interesting journey but so far and we had our challenges, but people are doing okay.

Do you have a favorite memory working in FSP?

Each client is different and in each case you are getting to know a different person and learn about what their wellness looks like for them. I don’t know if I have a specific memory, but when a client is moving towards graduating from our program and they’re starting to feel really proud of themselves and happy about what they’ve been able to achieve, that’s my favorite part. Every year we will do an update achievement plan goal and it’s nice to review the progress that someone has made and hear them reflect and talk about their experiences. They are truly survivors.

For more information about our older adult FSP program in partnership with SLO County Mental Health, visit their website or call the SLO County Mental Health access line at 1-800-838-1381 to hear more about what services are available for all people of different ages. If you or anyone needs someone to talk to, call the local hotline at THMA at 800-783-0607.