NAMI-NYC, Managed Care Pilot To Assist Consumers with MI
Mental Health Weekly June 17, 2013
The National Alliance on Mental Illness of New York City (NAMI-NYC Metro) and Beacon Health Strategies,
a managed care organization, are embarking on a public/private partnership to provide communitybased
outreach services and education for Beacon plan members with mental illness and to expand their
individualized care plans.
The year-long pilot program, slated to begin with 50 participants at the end of June, will educate program
participants on mental illness in general and about the importance of accessing community-based services.
Beacon officials will also measure the impact that the NAMI services will have on participating members’ knowledge of dealing with mental illness and the subsequent use and success of community-based services to support independent living.
“All across the country and in New York state, people on Medicaid with high healthcare needs, including
mental health, are moving from a fee-for-service to a managed care environment,” Wendy Brennan, MS, executive director of NAMI-NYC Metro, told MHW. In this environment, managed care organizations (MCOs)
are encouraged to identify services that are low cost but are able to reduce overall healthcare costs and improve outcomes, said Brennan.
Brennan added, “The health system is beginning to recognize the value of peer-family and consumer education support and involvement. There is little objective evidence to support those beliefs. The NAMI
project is important because it will provide preliminary objective data about the value of consumer and
The program is unique for families and consumers, said Brennan.
“Generally, no one is looking for partners in managed care. This is a terrific opportunity to look at a program that will impact outcomes,” she said.
MCOs generally adhere to the medical model, she said. “Beacon is really thinking outside the box and
working with an organization that provides family and consumer support and education,” she said. “Beacon
believes that involving patients and families impacted by chronic illnesses in their own care and that of
their loved ones will enhance wellbeing.”
Brennan explained that the medical community understands, to some extent, that patients and families
need to be involved in chronic illness management. “Few believe the same is true with mental illnesses,”
The pilot program will include two of NAMI’s peer-to-peer-led programs for people with families with mental illness or with serious mental illness, said Brennan. One of the programs that will connect participants
to community-based services is NAMI Basics - an education program for parents and other caregivers
of children and adolescents living with mental illness - taught by trained leaders who themselves are
parents and caregivers of children with mental illness.
The goals of the program include providing basic information for caregiving, helping the parent/
caregiver cope with the impact of mental illness and providing tools to assist in making the best decisions
for the child’s care. The NAMI Basics program lasts for six weeks, said Brennan, adding that the program
also enables parents and caregivers to work with the public mental health system better.
NAMI’s peer-to-peer program focuses on wellness and recovery and is taught by a team of individuals
who are living with mental illness.
“We’ve already added two physical health-related sessions that includes information about the importance
of addressing physical health to promote overall wellness and includes practical information about how to talk to your primary doctor, et cetera,” said Brennan.
“Beacon and NAMI have a long history together,” Alan Boardman, LMSW, New York state director of
Beacon Health Strategies, told MHW. “We have sponsored several NAMI walks in New York and in Massachusetts. We’re always looking for partners with community-based or peer-led organizations.”
The partnership, said Boardman, reflects the recovery mission at Beacon. “These services are never
meant to take the place of behavioral health services, but to augment behavioral health treatment,” he said.
NAMI will administer surveys before and after the intervention to measure the courses’ impact on
knowledge about mental illness, medications, stress management techniques and wellness management
skills. Additionally, Beacon will work with New York University’s McSilver Institute for Poverty Policy and Research to assist with data analysis and review of members’ subsequent service utilization.
Beacon and NAMI will assess any correlation between the use of NAMI services and the improved use of outpatient and preventive services to support community living.
“We want to take a look at how service utilization may shift after the intervention,” said Boardman. “We’re
hoping to see more use of preventive services through primary care or behavioral healthcare or both and
less on ER services and inpatient services.”
When a person goes to the ER for treatment for an acute [illness], there is very little follow-up, said
Boardman. “They don’t promote wellness; there’s no continuity of care,” he said. “They don’t see the
same doctor every time, so there’s no relationship with the provider.”
“We’re making sure that Beacon case managers and utilization managers, discharge planners at the hospital
and other behavioral health network providers are aware of NAMI’s services and weave them into their
care plans,” he said.
“The mental health field is notorious for not looking for objectives, outcomes and measurement,” said
Brennan. “It’s really held back the quality of mental health services that are available. The world is changing. Services are held up to higher mental health standards.”
Brennan added, “It’s really rare that an organization like NAMI gets to find a partner in the for-profit
world who’s committed to many of the same goals and understands our mission. I would certainly hope to
continue this effort statewide in the future.”