New Provincetown program navigates mental health system

April 21--PROVINCETOWN -- To help people move through the complex maze of behavioral health services and insurance coverage, Provincetown has created a program to prevent residents in need from falling through the cracks.

The Community Resource Navigator Program, which began this month, provides a full-time employee with knowledge of existing resources and the ability to stitch together the patchwork of services for each person.

The $100,000 in funding, approved by selectmen and then by town meeting voters earlier this month as part of the operating budget, also will partially pay for a master's-level social worker at Outer Cape Health Services to provide much-needed mental health counseling.

Those who need help the most are often the most underserved, because of their own challenges and the system's many pitfalls, Selectman Thomas Donegan said.

He learned that more than a year ago, when an acquaintance called him at midnight from an unknown number.

"It was a guy in the middle of an overdose," Donegan said.

The man could not move his legs and did not even know where he was, Donegan said.

"He was afraid to call the police," he said.

Although Donegan and police dispatchers helped the man that night -- it turned out he was in a motel room -- getting him follow-up care in the months afterward proved challenging.

"He had a lot of trouble figuring out MassHealth," Donegan said. "The AIDS Support Group helped a little, but it was more than they could manage. He is somebody with mental illness and drug addiction combined, and that made him particularly suspicious of the system and how to get help."

Provincetown's program is among dozens that have cropped up statewide and nationally. The opioid epidemic has brought to light the difficulty in navigating a behavioral health system that is only partly covered by health insurance.

Gloucester Police Chief Leonard Campanello responded by finding people with substance abuse disorders treatment beds from the lobby of his station. Much smaller groups, such as the Open Doorway of Cape Cod, based in Eastham, and Heroin Is Killing My Town, in Buzzards Bay, are made up of a few volunteers willing to make phone calls, drive and even pay for people to go to treatment.

In Provincetown, asking the police to be "the social workers of last resort" didn't seem fair, Donegan said.

The navigator program was designed for people who might be reluctant to seek help, because they have tried and failed, had a bad experience or simply do not understand what is available to them, said Marta "Dikke" Hansen, director of behavioral health services at Outer Cape Health Services.

"These people end up getting on the radar of the police and emergency medical services and it's not where they belong," Hansen said.

Hansen will seek referrals from the police, doctors and others who may have concerns about a particular person.

"We are hoping we can get quite a list," Hansen said.

Then, the navigator will reach out and try to build the trust necessary for the patient to get help.

Hansen, originally from a small town in Norway, said people there commonly received "wraparound services," which were tailored for the individual over time.

"Change is not a linear thing," she said. "It's stop and go. It takes all kinds of journeys."

Although the program is intended for Provincetown residents, Donegan said he doubted people from elsewhere would get turned away. Truro and Wellfleet should consider funding such a program as well, he said.

As part of the funding, Provincetown has hired the Institute for Community Health, a third party, to evaluate the program at the end of the first year.

-- Follow K.C. Myers on Twitter: @kcmyerscct.

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