Health

12 HE ALTH • Fall 2020 • By Monica Busch M ainstreamed depictions of health care often imagine a world wherein people go about their day-to- day lives until they feel sick, at which point they call their doctor's office and make an appointment for an exam. Somewhere typically in the mix is health insurance, a co-pay, and maybe a scheduled follow-up, or a prescription picked up at the local drug store. If debates about the Affordable Care Act and proposed universal health care haven't already made it clear, that idealized version of access isn't the norm for many Americans, and according to community health care providers, especially not for those who belong to vulnerable population groups who struggle with mental health challenges. While there are a multitude of factors at play, the burden of ensuring equitable access to mental health treatment has fallen in part on providers and advocates themselves, many of whom devote their careers to identifying who, exactly, needs care – and who isn't getting it. But since mental health issues are notoriously invisible, operating out of plain sight, often misjudged or carefully hidden, those providers are faced with two difficult questions: How do you determine people in the community who would benefit from treatment, and how do you convince them receiving treatment is a good idea? Open Sky Community Services, the Worcester-based nonprofit with a location in Northbridge, works to answer and disentangle those questions. Amy Arrell, director of peer, homeless, and drop-in services at Open Sky, said its outreach plan, which tackles these issues, functions in two main ways: establishing trust and maintaining a presence in the community. "So whenever someone has a need and expresses it to anyone in the community, we like them to then think about us, because they've seen us, they've met us," Arrell said. Open Sky, in particular, helps connect and provide its clients with a number of service options, including its own outpatient group, which provides group therapy and psychiatry, as well as drug and alcohol counseling. The organization keeps licensed mental health clinicians on staff who can provide short-term crisis management and interventions, and provides recovery coaching, as well as a 24-hour crisis support line, said Arrell. "We try to help someone immediately and provide the services they need so they don't have to run to this person and that person," Arrell said. Building trust Clients working with Open Sky often face multiple barriers to receiving care, and affordability is only one piece of the puzzle. Clients are often low- income and belong to an array of other vulnerable population groups, including those who are recently incarcerated, homeless or suffering from substance use disorder. Among other things, the folks Open Sky works with may not have identification, transportation or know how a smartphone works – basic necessities for accessing mental health care independently in 2020. In that vein, one key step to the organization's outreach plan involves making sure basic housing and safety needs are met first, before encouraging other types of treatment – with no strings attached to that assistance. "We approach the situation with no expectations," said Taylor LaCroix, division director of homeless, justice and addiction services. "A lot of folks that are engaged in our services have been told by the Helping others get help Human services organizations build trust and connect vulnerable populations with mental health care Taylor Lacroix, divi- sion director of homeless, justice and addiction ser- vices for Open Sky Community Services Skypixel | Dreamstime.com

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