OTTY 2019 Honoree: the gold standard

How do you talk to someone you believe may be experiencing some mental health issues? “I don’t think there’s any wrong way or right way,” said Dr. Sabina Lim. “You need to approach them in a way that reflects non-judgment. Think about talking to a person in a way that motivates a better way to address their symptoms. Ask questions like, ‘What do you want out of life?’ It can be a big goal or a small goal. Focus on the positive.

Lim, vice president and chief of strategy, behavioral health, for the Mount Sinai Health System, oversees about 60 outpatient clinics, 350-plus inpatient behavioral health beds, several pilot programs and more than one million ambulatory visits. Her core tenet is deceptively simple: “Mental illness shouldn’t be feared. You can live successfully with the right strategies in place.”

Part of the solution, Lim explained, is talking to other people who have been through your experience. If you have diabetes, hypertension, or asthma, you feel more comfortable talking to someone who has lived it. The same goes for mental health. You need to be with a circle of people who “get it.”

“We’re increasingly finding how valuable peer counseling is to engage mental health patients into treatment,” said Lim. The old model, where people in white coats tell patients what’s wrong with them, is, well, the old model. Lim uses the term “Demedicalized” to describe the new, more successful strategy she promotes to help patients.

Peer counselors are people who successfully manage their mental health challenges and work with others to help them address their own. These counselors are part of a new pilot program that deploys teams of trained specialists who intercede during mental health crises where they happen; in the neighborhood, family home, or even a subway platform.

In this effort,Lim’s department works with the National Alliance on Mental Illness (NAMI), a national grassroots mental health organization, and with Vibrant Emotional Health organization (formerly the Mental Health Association of New York City), which is on the forefront of public policy advocacy and education. These organizations, along with the state Office of Alcoholism and Substance Abuse Services (OASAS), the state Office of Mental Health,the city Department of Health and Mental Hygiene and others, form a literal mental health support army for the mobile outreach teams.

Mobile mental health teams have been in existence for years, but times and strategies have changed.“Our services used to be ‘medicalized,’” said Lim. “Our approach is now ‘patient based.’” Response times used to be as much as 48 hours. “We’ve now reduced this to two hours,” Lim was happy to report. The teams can respond faster, meet with the patient at their location, determine if they need assistance, and if so, what kind. This greatly reduces the stress on emergency rooms, and places the patients in programs that best suit their diagnoses.

One exciting result of the program’s success is that it can be replicated. Dr. Lim recently shared her mobile response program, and its results, with Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services.

“We want to be the Gold Star Standard on how behavioral health services are delivered,” said Lim, “leading the way forward, and a major contributor to the national outreach for patient-centered treatment”