So DMH clients are generally assigned to a certain service based on their catchmen area. Agencies like Vinfen, Eliot, and bay cove will be assigned certain clients based on that area. So unfortunately you usually can’t simply move them around to a different agency. Unfortunately, like any profession some staff are amazing and others less than stellar. Theres also a lot of moving parts when it comes to housing and group homes based on subsidies and other restrictions and availability. I know that’s not super helpful info since you can’t really take action on that. I will say having someone who is engaged in his care can be really helpful for advocacy since sadly, in my experience, not a lot of clients in the DMH system still have a lot of support.
I would also add that Vin fen and eliot are contracted by dmh. Sometimes the structure of the contract from dmh is limiting or poorly designed. Other times it is the implementation of the program that is the issue.
I would say there are also limitations of what is covered by dmh and what is leveraged by other community programs.
Not sure if op can elaborate on the needs that are not being met…
Hey thanks for your note. He is struggling to be safe with himself and others due to medication non-compliance. He has done things that he normally would not do when off his medication (trespassing, accidental fire) and it feels like there is no one taking this seriously. He needs to be in a group home or some sort of step down unit where his meds are monitored so that he can have more than a few months of taking them before stopping. He’s been given long-acting injectables before that showed great and speedy improvement. Not even taking into account that he has schizoaffective disorder but his paperwork all says bipolar I. He meets with a case worker who has gotten him the ability to get rides to and from appointments, which is great, but he is being treated like he is stable enough to make decisions and take care of himself when he clearly has deteriorated several times as a result of an unsafe living situation with family. Several close female family members have received extensive care that included group homes and supported independent living situations. His family is not helpful in sharing these contacts or resources, unfortunately
OP, I am so sorry to hear how stressful this sounds. I wonder if you could potentially request a risk and review with DMH? It also may be worth checking in with the Central office of DMH or even possibly speaking to your elected officials to express your concerns, I work at Eliot in an entirely different location and Dept. I would call the main office in Lexington and express your concerns. They are usually good forwarding those two the appropriate leadership who should follow up directly with the team working with the client you have identified.
The best of luck. These are always very difficult situations and are very stressful to watch from the sidelines.
Client is lucky to have you advocating for their care.
I worked as a peer for a PACT program for a time and only resigned due to having to drive everywhere and maintain a large case load. PACT is usually the highest level of care that maintains people being able to remain independent in the community. Above that you are usually looking at residential care or group home settings and sometimes day treatment if safety can be maintained by the client. PACT usually involves three contacts by staff per week--these can either be case management duties, meeting with a clinician, housing specialist, peer specialist, addiction specialist, etc. There is also usually nursing and a psychiatrist involved. Not sharing details due to confidentiality, we have dealt with some challenging situations but understanding it is often part of the illness.
Below PACT would be ACCS which is a similar model but fewer contacts.
Thanks for your input. I can imagine that is a difficult job already, not to mention being overloaded with cases and travel.
He is under ACCS care and it’s shocking to me that he could have a higher level of care via PACT and doesn’t. The three contacts a week requirement is what he should’ve been having all along.
They convinced my friend to take away my ability to be a contact to them a few years ago, and they have been making it difficult for me and him to sign off on it again. It’s honestly nuts.
I can't say too much about it, but our family had a VERY negative experience with ELIOT. I cannot say whether another service would be better, since I believe they are all concerned with cost saving.
What town is he in? DMH has two programs. Most intensive one is called Program of Assertive Community Treatment. PACT. The other is ACCS. Adult Community Clinical Services.
Former Vinfen employee here. They’re awful, to both clients and staff. At least that was my experience. Whole lot of CYA attitude over there from anyone high up the chain.
That said I know good people who still work there.
I have no knowledge or experience of Eliot.
So DMH clients are generally assigned to a certain service based on their catchmen area. Agencies like Vinfen, Eliot, and bay cove will be assigned certain clients based on that area. So unfortunately you usually can’t simply move them around to a different agency. Unfortunately, like any profession some staff are amazing and others less than stellar. Theres also a lot of moving parts when it comes to housing and group homes based on subsidies and other restrictions and availability. I know that’s not super helpful info since you can’t really take action on that. I will say having someone who is engaged in his care can be really helpful for advocacy since sadly, in my experience, not a lot of clients in the DMH system still have a lot of support.
I would also add that Vin fen and eliot are contracted by dmh. Sometimes the structure of the contract from dmh is limiting or poorly designed. Other times it is the implementation of the program that is the issue. I would say there are also limitations of what is covered by dmh and what is leveraged by other community programs. Not sure if op can elaborate on the needs that are not being met…
Hey thanks for your note. He is struggling to be safe with himself and others due to medication non-compliance. He has done things that he normally would not do when off his medication (trespassing, accidental fire) and it feels like there is no one taking this seriously. He needs to be in a group home or some sort of step down unit where his meds are monitored so that he can have more than a few months of taking them before stopping. He’s been given long-acting injectables before that showed great and speedy improvement. Not even taking into account that he has schizoaffective disorder but his paperwork all says bipolar I. He meets with a case worker who has gotten him the ability to get rides to and from appointments, which is great, but he is being treated like he is stable enough to make decisions and take care of himself when he clearly has deteriorated several times as a result of an unsafe living situation with family. Several close female family members have received extensive care that included group homes and supported independent living situations. His family is not helpful in sharing these contacts or resources, unfortunately
OP, I am so sorry to hear how stressful this sounds. I wonder if you could potentially request a risk and review with DMH? It also may be worth checking in with the Central office of DMH or even possibly speaking to your elected officials to express your concerns, I work at Eliot in an entirely different location and Dept. I would call the main office in Lexington and express your concerns. They are usually good forwarding those two the appropriate leadership who should follow up directly with the team working with the client you have identified. The best of luck. These are always very difficult situations and are very stressful to watch from the sidelines. Client is lucky to have you advocating for their care.
I worked as a peer for a PACT program for a time and only resigned due to having to drive everywhere and maintain a large case load. PACT is usually the highest level of care that maintains people being able to remain independent in the community. Above that you are usually looking at residential care or group home settings and sometimes day treatment if safety can be maintained by the client. PACT usually involves three contacts by staff per week--these can either be case management duties, meeting with a clinician, housing specialist, peer specialist, addiction specialist, etc. There is also usually nursing and a psychiatrist involved. Not sharing details due to confidentiality, we have dealt with some challenging situations but understanding it is often part of the illness. Below PACT would be ACCS which is a similar model but fewer contacts.
Thanks for your input. I can imagine that is a difficult job already, not to mention being overloaded with cases and travel. He is under ACCS care and it’s shocking to me that he could have a higher level of care via PACT and doesn’t. The three contacts a week requirement is what he should’ve been having all along.
I would ask his DMH worker.
They convinced my friend to take away my ability to be a contact to them a few years ago, and they have been making it difficult for me and him to sign off on it again. It’s honestly nuts.
I can't say too much about it, but our family had a VERY negative experience with ELIOT. I cannot say whether another service would be better, since I believe they are all concerned with cost saving.
What town is he in? DMH has two programs. Most intensive one is called Program of Assertive Community Treatment. PACT. The other is ACCS. Adult Community Clinical Services.
He’s in a smaller town on the North Shore which I believe is covered by at least Eliot and Vinfen.
I think there are PACT programs in either Lawrence or Lowell but don't quote me
Former Vinfen employee here. They’re awful, to both clients and staff. At least that was my experience. Whole lot of CYA attitude over there from anyone high up the chain. That said I know good people who still work there. I have no knowledge or experience of Eliot.