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An outpatient relational health unit for children in Lubbock, Texas, and a crisis receiving center in Missoula, Montana, are among the programs that got funding in the first round of what Providence's Well Being Trust plans to make an annual grant process.

The trust awarded nearly $5 million for 29 new behavioral health initiatives in communities across the footprint of Providence St. Joseph Health in Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. Dr. Arpan Waghray, the foundation's CEO, says the grants went to programs that are innovative and transformational for communities.

Providence sites submitted more than 50 applications for grants. The requests totaled three times what the trust had budgeted. "This is happening just on the other side of the COVID pandemic, so one would imagine that our caregivers are hard-pressed to take on new initiatives, but I'm so proud to be a person of Providence where our people care so deeply about these challenges that patients and community members are experiencing," Waghray says.

Providence established the trust in 2016 with an endowment. Its goal is to advance mental, social and spiritual health across the nation. Last year, it shifted its focus inward to support programs in the communities the health system serves, with the hope that those programs can be refined and proved scalable elsewhere.

Waghray says the idea behind the grant allocation was simple: "How do we empower the people on the front lines to partner with their patients, families and community members to address some of the most challenging issues and deepest problems that communities are facing?"

He adds that all the programs funded by the grants are aligned with Well Being Trust's strategic priorities of expanding access to care, raising the quality of care, and improving mental health and resilience in communities.

Pediatric mental health care
Covenant Children's in Lubbock got a grant for its Relational Health Center that opened in August. Dr. Amy Thompson, Covenant Children's CEO, says the unit will address the lack of services in Northwest Texas for those 18 and younger who need mental health care and the disconnect among the services that do exist.

Post-COVID data from Covenant's emergency department shows that the number of patients who are in a mental health crisis has tripled. "While the number of kids entering our ED in crisis is staggering, unfortunately an even larger number are not making their way to seek care," Thompson adds.

Covenant's new unit houses spaces for psychiatry appointments, an intensive outpatient program and a partial-day hospitalization program. In addition to psychiatrists, the unit is staffed by a pediatrician, counselors, therapists and social workers. In time, Thompson says, Covenant hopes to add inpatient care.

"Our goal is to try to put all of those services together and run them out of the same place so that they're coordinated," she says.

The unit is being operated in partnership with the Texas Tech University Health Sciences Center. Covenant has a long-standing collaboration with the university, with the school providing physicians and the hospital offering opportunities for medical students and residents.

Waghray says the grant approval process included whether the programs have partners that are grounded in the community and willing to provide support. Other criteria were how many people the programs had the potential to reach, whether they had a built-in health equity lens to ensure that those who are often marginalized are served, and whether they had a long-term sustainability plan.

Crisis receiving center
A partnership called the Strategic Alliance for Improved Behavioral Health is behind the crisis receiving center set to open this month in Missoula. The alliance includes Providence St. Patrick Hospital and several other mental health care providers in the community as well as city and county agencies and people who have lived experience with mental health conditions and substance use disorders.

Jeremy Williams, a nurse who is director of behavioral health at St. Patrick Hospital, says Missoula County has a lack of outpatient mental and behavioral health resources for people in its population of about 120,000.

"You really have this no man's land or gray area for folks that are in need of resources as they are going through crisis," Williams says. "They might not need an acute admission, but still need those supportive resources, such as seeing a therapist or doing some resource planning."

Adults will be able to check themselves into the receiving center for stays of up to 24 hours. They can rest, be examined by a nurse, talk with a counselor, and seek out longer-term resources. The center will be open 24/7 and staffed by a nurse, a mental health technician, a security officer, a social worker or therapist, and a peer support counselor. The grant from Providence's Well Being Trust will assist in underwriting some of the center's initial operation expenses.

Creating a warm welcome
To ensure that the care is respectful of indigenous communities, the center's planners consulted with the nonprofit All Nations Health Center. One of the accommodations that resulted was space for patients to conduct smudging ceremonies, a cleansing ritual involving sacred herbs.

"We wanted to create a warm welcome within so that people feel like they can reach out whenever they need assistance," Williams says. "We will have staff there waiting to help regardless of race, creed, faith, gender — whoever they are and wherever they're coming from."

As with all the programs it supports, the trust will be analyzing data from the grant-funded initiatives, Waghray says. The foundation will be checking whether the initiatives are helping it advance its goal to provide access to behavioral health care to 1 million more Americans and lifesaving interventions to 100,000 patients over the next three years.

"We're doing this important work to save lives," Waghray says.