Implementing COVID-19 Mitigation in the Community Mental Health Setting: March 2020 and Lessons Learned

Abstract

In March 2020, at the beginning of the COVID-19 pandemic, state-funded community mental health service programs (CMHSP) in Michigan, organized into 10 regions known as a "Prepaid Inpatient Health Plan" (PIHP), grappled with the task of developing a modified plan of operations, while complying with mitigation and social distancing guidelines. With the premise that psychiatric care is essential healthcare, a panel of physician and non-physician leaders representing Region 5, met and developed recommendations, and feedback iteratively, using an adaptive modified Delphi methodology. This facilitated the development of a service and patient prioritization document to triage and to deliver behavioral health services in 21 counties which comprised Region 5 PIHP. Our procedures were organized around the principles of mitigation and contingency management, like physical health service delivery paradigms. The purpose of this manuscript is to share region 5 PIHP's response; a process which has allowed continuity of care during these unprecedented times.

Keywords: Behavioral health; COVID; COVID-19; Community mental health; Community mental health and covid-19; Coronavirus; Mental and physical comorbidities and covid-19; Mental health; Psychiatry; Telehealth guidelines.

Fig. 1

Organizational structure of community mental health service providers (CMHSP) in Michigan

Fig. 2

Process for developing mitigation strategies based on Delphi Method