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Case Studies

Providence St. Joseph Health

Brief description: In 2016, Providence Health & Services in Renton, WA and St. Joseph Health in Irvine, CA joined forces to create Providence St. Joseph Health (PSJH), an organization focused on improving the health of the communities it serves, especially those who are poor and vulnerable. PSJH employs 111,000 caregivers, who serve in 50 hospitals, 829 clinics, and a range of services. Since its founding, PSJH has certified 45 of its employees as Mental Health First Aid (MHFA) instructors.
A public health oriented approach
After PSJH was formed, it made a commitment to focus on behavioral health and wellness, with an emphasis on early intervention. PSJH highlighted that one of the top three reasons people go to the emergency room is because of an existing mental health disorder, and that many patients in the ER are people who could be better served elsewhere. The thought behind prioritizing an early intervention approach on mental health was that if PSJH could intervene sooner, then it could hopefully avoid some acute care situations. Bayley Raiz, Senior Director of Mental Health & Social Care Management at Providence St. Joseph Health, highlighted the importance of early intervention, saying, “Intervening as soon as people need help allows us to avoid more acute levels or involuntarily commitments.”
In October 2016, in an effort to catalyze a larger national movement towards destigmatizing mental health, PSJH’s leadership decided to make grants to two national nonprofit entities: the National Council for Behavioral Health (NCBH) and the National Alliance on Mental Illness (NAMI). When asked about the rationale behind these grants, Jason Lacsamana, Program Officer of the Community Partnership Fund at St. Joseph Health, said, “We wanted to open the dialogue on mental health in our communities in a meaningful and tangible way by using an approach that goes beyond the walls of our hospitals but supports our clinical resources. We know we can’t do this alone and that this has to be a community-wide solution.” Mental Health First Aid provided an opportunity to improve mental health literacy at the community level, and provided community members with the tools necessary to support their neighbors experiencing mental health issues. NCBH received $700,000 with the goal of delivering 1,300 MHFA courses and training 50,000 people as first aiders. MHFA will also certify 60 PSJH employees as MHFA instructors.
According to PSJH, NCBH’s history, reputation, and national advocacy efforts played a role in its selection as a grantee. Particularly, MHFA’s innovative, evidence-based curriculum was a key differentiator. Dora Barilla, Group Vice President of Community Health Investment at Providence St. Joseph Health, explained, “We saw MHFA as an initiative that in many ways was already vetted.” Beyond the established reputation of MHFA, Raiz emphasized the accessibility of the training, saying, “One of the beautiful things about MHFA is that it is an accessible approach, so you don’t have to be a psychologist or other mental health professional to understand the training and utilize it to refer an individual to the right resources.” In addition, Lacsamana recognized the value of training people in MHFA by highlighting, “Once you train individuals, there is an impact that lasts beyond the grant period. It’s an investment in sustainable human capital.”
Results of MHFA
Since October 2016, PSJH has certified 45 of its caregivers as MHFA instructors. Beyond the number of certified instructors, there has been a shift in the culture around mental health at PSJH. Raiz highlights this change in culture by saying, “Typically, when we don’t know how to respond to something, we pretend we didn’t see it. However, MHFA normalizes mental health concerns, so that when these mental health crises occur, we can address the situation head on.” Beyond the internal impact of MHFA at PSJH, the training has also opened doors for the organization to build new relationships with partners in the community.
Future direction of MHFA
In regards to future plans for MHFA at PSJH, the organization hopes to certify an additional 15 employees as instructors and expand the number of trainings it offers. Beyond MHFA, PSJH is interested in trauma-informed care and is in the process of looking for other tools that can complement its offering of MHFA. In an effort to bolster its population health approach, the organization hopes to determine what community indicators are attributable to a behavioral health concern, such as avoidable emergency room visits or legal involvement. Lastly, Raiz emphasized that “where you are in our organization really determines what you see as a need in the mental health arena.” As a result, in an effort to accommodate for this variability, PSJH is in the process of developing a measurement dashboard, which will track behavioral health indicators for clinical practice, organizational outcomes, and the communities at large.