Virgin Islands Department of Health (D.O.H.) Commissioner Justa Encarnacion, during a Committee on Health, Hospitals and Human Services hearing on Monday said D.O.H. plans to improve care for St. Croix’s struggling mental health community by retrofitting a facility in Anna’s Hope that offers both inpatient and outpatient care. The department will also reopen the Charles Harwood Complex Clubhouse in August to offer increased out-patient mental health services.
Senator Marvin Blyden noted that Former Governor Kenneth Mapp declared a state of emergency on mental health in September 2016, and Governor Albert Bryan did the same in March of this year. Mr. Blyden asked Ms. Encarnacion how the declaration has helped in addressing some of the major mental health issues in the territory. Ms. Encarnacion said the declaration has brought more focus to the growing issue; it has alerted other cabinet members to adhere, listen, and assist in ongoing projects; has allowed for more rapid hire of D.O.H. personnel; and has alerted the Legislature to assist with funding needed to improve the department’s processes.
Anna’s Hope residential facility
The Anna’s Hope property the Dept. of Health intends to use for the mental health inpatient residential services is a one-story building of approximately 5,000 square feet that can accommodate up to twelve patients. The project will be all inclusive for persons suffering from, or diagnosed with behavioral health challenges or mental health disorders, and will provide care 24 hours a day, 7 days a week.
D.O.H. is also in the process of assessing government property and rental homes to establish another residential facility on St. Croix, and plans to contract an off-island transitional care team, not yet identified, equipped to manage it. D.O.H. intends to hire a project manager with behavioral health residential expertise.
The inpatient services the department intends to provide will be geared towards individuals who need constant medical supervision, and persons with relatively severe, long-term symptoms who have not shown significant progress after outpatient mental health intervention. Individualized counseling, group therapy, medical supervision, recreational therapies, and culturally sensitive therapies will be offered, the department said.
Outpatient treatment services will also be offered to those suffering from mild to moderate symptoms, those with a strong support system, and those with the ability to function outside the treatment center. Treatment will include individualized counseling, group therapy, family therapy, intensive outpatient care, partial hospitalization, and psychiatric medications and outpatient medical management.
Senator Kurt Vialet inquired as to when the work at the Anna’s Hope property would begin, since the Senate already provided $4 million in the 32nd Legislature and $3 million appropriated from the 33rd. “The people are not seeing the direct impact of those monies,” Mr. Vialet said. “They are not seeing what is being done to improve the problem. Because of this, the Legislature has requested that you submit a comprehensive plan addressing the problem by August 30 that will tell exactly how you are going to touch those individuals on the street.”
Charles Harwood Complex Clubhouse
The Charles Harwood Complex Clubhouse model will offer membership to programs focused on normal social and recreational opportunities, rolled out in phases, designed to support persons living with behavioral health challenges or mental health disorders. The focus stressed for participants will be a work-ordered day; employment programs and weekend activities; family and community support; out-reach services; supported education; housing support; decision-making and governance; and an environment where empowerment, illness management and recovery, relationship building, and skill development and related competencies are stressed, the department said.
D.O.H. sourcing solutions
The department said it has conferred with community leaders, Judge Harold Willocks, Wynnie Testamark, director of bureau of corrections, and Kimberly Causey-Gomez, commissioner nominee of Department of Human Services, on ways to better serve the behavioral health forensic population and reduce the cost to the territory.
D.O.H. has also conducted town hall meetings on each island for the last six months and said it recognizes the need for additional staff. The St. Thomas staff will be traveling more often to St. Croix to provide needed outreach services, as St. Croix currently lacks adequate personnel to perform duties.
Mr. Blyden asked D.O.H. officials whether the department had analyzed the cost of St. Thomas staff traveling to St. Croix, and whether it was more feasible to hire employees on St. Croix to perform those services. Ms. Encarnacion said she recognized that funding has to be considered.
“Federal grants are being used to pay for those services right now as needed. We have opened vacancies and moved individuals, not as critical to other areas in the department, into the behavioral health department. We have communicated our need to the [Office of Management and Budget] and we are looking to recruit more individuals. We do realize that St. Croix does need more behavioral health outreach as well,” she said.
The department’s director, Vernita Bicette, and her executive team recently met with members of the Substance Abuse and Mental Health Services Administration (S.A.M.H.S.A.) and a representative from the Health Resources and Services Administration (H.R.S.A.) who provided an overview of the six grants totaling $2.8 million that the department’s behavioral health division is responsible for and the deliverables under each grant. The director intends to work closely with each program manager to ensure that those deliverables are met in a timely manner.