Otonichar describes GP, MO, STEP, PACE, and Bellevue care levels
Otonichar explains that most patients with mental health needs are housed in general population and seen in clinics. He details specialized units including 17 mental observation units, the STEP program, 10 PACE units, and a 20-bed PACE unit at Bellevue.
Most patients who have mental health needs in the jail system are appropriately housed in the general population, or GP, and meet with mental health clinicians in the clinic for their appointments similar to an outpatient model of care in the community.
The jail-based mental health therapeutic housing units, conversely, are designed for patients who have more robust mental health needs and require increased clinical observation and care coordination.
These units offer a continuum of care leading up to units that are akin to residential treatment facilities in the community, with CHS mental health staff primarily working on the units to provide enhanced treatment interventions.
For patients who benefit from a level of care higher than outpatient general population, CHS established mental observation or MO units, of which there are currently 17.
Patients on MO units are rounded on regularly by mental health
and received enhanced clinical monitoring and support.
Earlier this year, CHS also implemented the Supportive Transitional Engagement Program, or STEP, within the Mental Health Therapeutic Housing Continuum.
STEP serves as an intermediary level of care between MO and GP.
The most intensive level of mental health care CHS provides on Rikers Island is the Program to Accelerate Clinical Effectiveness, or PACE.
These units house clinically vulnerable patients who have the most complex mental health needs, including persons with serious mental illness and or developmental disabilities, for whom a lower level of care is not optimal.
There are currently 10 PACE units in operation, including a 20-bed PACE unit within the outposted therapeutic housing unit at Bellevue Hospital that houses patients who have comorbid psychiatric and medical complexities.
Within each of our PACE units, a multidisciplinary team, which includes mental health clinicians, creative arts therapists, treatment aides, and social work and nursing staff, works with each patient to provide coordinated care.
CHS mental health clinicians continuously assess the patient's therapeutic needs throughout the individual's time in jail.
As those needs change, CHS works with DOC to more appropriately house that individual.
If a patient requires a higher level of care than can be offered in the jail setting, CHS initiates transfer to an
acute psychiatric hospital for evaluation and possible admission.