Building stronger communities…person by person
By Sonia Duggan
The mental health crisis in America exacerbated by the COVID-19 pandemic prompted over 12,452 Collin County residents to call LifePath Systems crisis hotline for help last year.
As the county’s MHMR center, CEO Tammy Mahan wants residents to know their goal is to build stronger communities by supporting individuals and families impacted by behavioral health as well as those with intellectual or developmental changes.
“The center provides lots of great services which are ready for the community and the community definitely needs lots of stuff right now,” she said.
Mahan, a licensed professional counselor, has worked her way up through the ranks for over 25 years at LifePath. She assumed the role of CEO in February 2020 – right before the pandemic hit – and was quickly faced with a number of challenges.
“One of my first jobs as CEO was to figure out what is this ‘thing’ they’re calling essential services and are we one?” That wasn’t a term anybody necessarily used back before March of 2020,” she said.
LifePath is an essential services provider, says Mahan, “because we manage the crisis, we have a crisis hotline, and anytime somebody is in crisis we tend to be involved especially if they’re on Medicaid or indigent.”
In addition to crisis services, LifePath’s nurses and doctors had to continue to see the patients who were on injectable psych meds “to maintain their functioning and so they couldn’t stop that,” she said.
In mid-March, Mahan said they had to figure out how to operate safely which meant getting their hands “on a lot of PPE – a lot of masks and stuff that we typically don’t use every day – so there was a couple of weeks, probably a month, that was very stressful as we were trying to operate.”
Once they received PPE and funds to purchase lap-tops for everybody, Mahan said about 70% of their employees began working from
home doing telehealth. While that was helpful, she said about 30% of their services just couldn’t stop, “it had to be face to face, so we carved out ways to do that as safely as possible.”
Since 1986, when the system was first created by the Collin County Commissioners Court, LifePath has been offering a variety of services to Collin County residents.
LifePath Systems has to follow all rules as a unit of local government. They are not county employees, just controlled and authorized by the county. They are governed by a board of 10 individuals including Prosper Chief of Police Doug Kowalski and Wylie Chief of Police Anthony Henderson.
“We’re not just a nonprofit, Mahan said, “We have an obligation to serve the community.”
That obligation – funded by county, state and federal taxpayer dollars – helps serve needy individuals in Collin County.
“Most (services) are free, especially if you earn 200% above the poverty level or less – if you make more than that there could be some small copayments based on the income,” she said.
Mahan remembers the days when they had about 150 employees 20 years ago. The majority of the growth, she said, has been in the past five to 10 years. LifePath now has 481 employees.
“The past two legislative sessions have been very good for mental health, partly because of some of the terrible things that have happened across the state with school shootings, so the legislature has been more willing to invest more funds in mental health,” she said.
In 2020, 8,545 individuals received mental health care from LifePath.
Although the need for help has increased substantially, the main thing Mahan said she wants people to know is that help is available right away. Anyone can call the crisis hotline – 877-422-5939 – 24 hours a day, seven days a week.
“It’s a good first step,” she said. “If you’re not sure how else to connect with us, that would be a great way.”
When a call is made to the hotline, a licensed professional talks each person through whatever is going on, and if it’s just a routine case, a counselor will reach out.
“If it’s a crisis and they do need immediate services, they should call 9-1-1 if it’s that bad,” Mahan said. “Or we discharge our mobile crisis outreach team, which is a team of two licensed professionals who go out and talk to the person or family about what’s happening and what kind of needs do they have.”
If they need a hospital bed, Mahan said they can arrange that as well. If that’s not the case, they’ve got alternative ways to get people stabilized.
Since the pandemic, Mahan said they’re now seeing more and more people suffering from depression, anxiety and isolation, “and there’s definitely been an increase in suicide attempts.”
For those seeking help, LifePath has psychiatrists, nurse practitioners and over 50 counselors on staff. In an effort to promote same day services, each new patient visits with a doctor via telehealth, often within 30 minutes, said Mahan, “then they do an intake to determine what it is they need and if they need a doctor.”
“It’s rare that somebody can get in to see a specialist like a psychiatrist that quickly but it’s definitely important in our line of work,” Mahan said.
It’s not just adults who need help. Mahan said children ages 3-17 can often have a wide range of things going on such as ADHD, attachment issues, trauma from abuse and more.
“A lot of them are really struggling and could benefit from our services,” she said.
Two years ago, Mahan said LifePath started another service called Coordinated Specialty Care that is designated for teens who have experienced an episode of psychosis, which she said, “is not a common mental health issue.”
Although schizophrenia only affects 1 or 2% of the population, Mahan said it can be very disabling. For that reason, LifePath has a contract with the state to run an early intervention program for kids who have had their first episode of psychosis. By directing really intensive services to the teen and the teen’s family within the first two years of that first episode and getting them stable, Mahan said research shows they have much better outcomes and it’s likely they’ll never have to go into the hospital for a long term commitment, “which nobody really wants.”
“If you’re a parent and your child is talking about demons or whatever it is that they’re hallucinating or hearing, it can be very terrifying,” she said. “We provide lots of education about their options on medications, and none of it is mandatory. We really encourage them understanding whatever illness it is,” she said. “It could be the initial beginnings of bipolar with psychosis. It could be schizophrenia. It could just be depression with psychosis.”
Mahan said the team puts lots of energy at getting an accurate diagnosis and treatment plan and making sure everybody feels comfortable.
“The biggest thing I’ve learned over the past 25 years in counseling psych patients has been the earlier the intervention, the better,” she said. “Because if you don’t, there’s a lot of trauma that accumulates that really can weigh on an individual for the rest of their lives and hold them back. So, if we can prevent some of that from ever happening then that’s where you’re really making some huge improvements.”
A new program LifePath launched this year is the Local Outreach for Suicide Survivors (LOSS) Team. The program includes a team of mental health professionals and/or volunteers (must meet specific requirements) who provide outreach and support to family and friends of those lost to death by suicide.
“After a death has been ruled a suicide, then they (medical examiner or law enforcement) will call us in and we’ll meet,” Mahan said. “If the family wants it, they have to give consent, and if the family doesn’t want anything to do with us, we won’t bother them.”
The whole concept behind the program, says Mahan, is to help reduce future suicides. “Because, unfortunately we know if somebody in your immediate family commits suicide, it increases the risk for everybody,” she said. “And that’s definitely true with teenagers. So, we definitely want to be proactive and try to help lessen that risk and get people the services they need, even if it’s just short-term support. Everybody’s not going to need ongoing full mental health services, but they’re going to need some support because that is very traumatizing for the whole family involved.”
For the LOSS program, LifePath is looking for volunteers – anyone who has suffered the loss of someone to suicide would be a candidate because they know what the survivor’s friends and family are dealing with.
“That peer to peer relationship is really important,” Mahan said.
Expanding the public’s knowledge about the services LifePath provides is important to the CEO. Mahan said they work very closely with hospitals, schools, churches, service organizations and all law enforcement agencies, “as they tend to be the mental health professional if we’re not there.”
Mahan said officers are proactive and hand out LifePath’s crisis hotline cards anytime they come across families where they suspect something’s going on mental health-wise and maybe they need resources.
“They would rather have mental health professionals take care of these cases,” she said. “And it’s so much easier if people just reach out before it gets so bad that people are afraid for their lives.”
One way to get people involved in recognizing when someone is experiencing a mental health crisis is through community education.
LifePath offers Mental Health First Aid training at no charge to teachers, coaches, churches and businesses. The course teaches how to identify, understand and respond to signs of mental illness and substance use disorders. The nonprofit arm, LifePath Foundation, also raises funds for the program so any Collin County resident can take advantage of the course as well.
Participants are taught a 5-step strategy: to access risk of suicide or harm, listen without judgement, give reassurance and information, encourage appropriate help and encourage self-help and other strategies.
Although there was a dip at first in those seeking help for substance abuse when Collin County went on lockdown, Mahan said that changed soon afterward.
Last year, LifePath treated 839 residents for Substance Use Disorders. Alcohol was the number one substance abused, followed by methamphetamines and opiates.
Alcohol is the one thing that Mahan said scares her the most. “It’s so easy to get. It’s also one of the most dangerous as far as if you drink too much too often, detoxing from alcohol is very dangerous,” she said.
According to Mahan, alcohol was the way the public was managing some of the (pandemic) stress, and as a result, they were seeing “an increasing numbers of people needing detox last year.”
Because of this, Mahan said those in need of detox were showing up in emergency rooms and LifePath staff had to assess and determine where to place them in the system depending on their need.
The center provides outreach, screening, assessment and referral (OSAR) for Collin County residents seeking help with addiction. OSAR counselors are accessible at any of the two LifePath locations where they will conduct the initial assessment to determine what kind of level of care they need. If the assessment confirms a person definitely needs detox, LifePath gets funds from the state to place people at a residential rehab facility where they stay a week, which is then followed up with outpatient services.
Staff will make the recommendation, says Mahan, though it can’t be done against their will.
“Just because we want to send them off to residential (treatment) doesn’t mean we can force that necessarily,” she said.
By contracting with providers throughout the area, LifePath is also a provider of outpatient substance abuse offering group and individual therapy several hours a week.
“We also have funds for medication assisted therapies for substance abuse,” Mahan said. Therapies include either methadone, buprenorphine or some of the different medications, especially those used to treat opioid abuse.
If methadone treatment is needed, Mahan said they contract with centers in McKinney or Plano and they will work with the individual to see where they want to go.
“And then if somebody comes in and they have insurance, then we help them find what’s in their network,” she said.
For youth with drug problems, Mahan says they treat ages 12 and up.
“And if they’re under 12, then we tend not to treat them in the substance abuse arena,” she said. “They’ll probably have a dual diagnosis because there’s probably something else going on.”
IDD/Early Childhood Intervention
Any parent of a child over three years old with any kind of intellectual or developmental delay (IDD) can contact LifePath about its services.
In 2020, LifePath assisted 2,728 individuals with IDD, a program which provides parents/caregivers with a service coordinator to help develop a service plan, budget development and much more. Due to the demand for the program and its services, Mahan encourages anyone interested to apply right away.
Program participants can apply for a County Support Grant for up to $2,500 per year to use for a variety of services and therapies. LifePath also offers a Supported Employment Program as well as a Residential and Home and Community-Based Service program with two, six-bed group homes in Plano – one for women and one for men. According to lifepathsystems.org, the housing programs are funded through the Medicaid Intermediate Care Facilities for Individuals with Intellectual Disabilities.
“And so, for that (program) it’s really important that they call us to find out what they could be eligible for and to get on any possible waiting lists, because some of the waiting lists are quite long – up to like 15 years long,” Mahan said.
The most popular LifePath program is Early Childhood Intervention (ECI) for children ages birth to three years old with disabilities or delays in their development.
In 2020, 3,230 children received services from LifePath, for a total of 29,191 hours of service. Aside from screenings and assessments, services include physical, occupational, speech and language therapy, assistive technology and much more.
“That’s by far our most popular service,” Mahan said. “Because we’re helping babies and we’re helping those families that are stressed and they don’t know what to do to help their child.”
Mahan said due to the pandemic and people isolating, they were concerned that a lot of parents didn’t take their children to their pediatricians last year.
“Activity at different pediatrician and PCP offices was way down, and so the concern is that there are a lot of people out there that we need to be identifying and we’ve got a very short amount of time to get services to them,” she said.
After age three, children are no longer eligible for the services, of which many are paid with federal funds directed at identifying babies needing help and “getting them closer to being on track with their peers, especially before they are about to enter the school system.”
Mahan said any parent concerned with their child’s development can self-refer to their facility. “It doesn’t have to go through their pediatrician,” she said.
While referrals to LifePath were way down over the past year, Mahan said March 2021 was their highest (referral) month in a long time.
“I think we’re starting to have people identify and venture outside and see their pediatricians and they’re starting to acknowledge that there are problems,” she said.
Testimonies – and there are many – posted on lifepathservices.org validate the work Mahan and her staff are doing for the communities they serve.
“I don’t know where my son would be had ECI not been able to provide this critical service (speech and language therapy) not only to Sam, but to our family,” Sam’s parents wrote. “It has been wonderful to see Sam continue to progress and be able to communicate with our family.”
Behavioral Health clinic:
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