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Toward Local Care (TLC)

TLC programs provide residential and rehabilitative services to help patients integrate into their communities, while properly addressing clinical needs and the safety of the patient and the community, and providing stabilization services that assist individuals in distress without hospitalization.

People who have a serious mental illness do better clinically when treated in the community rather than living in state mental hospitals. They get better faster and stay better longer when they receive services in their community, if these programs meet their needs and are well organized and easily available. The closeness of family, friends, and community support aids in their recovery process.

The Spartanburg Area Mental Health Center is committed to enhancing treatment in the community by developing community programs that provide residential and rehabilitative services to help clients integrate into their communities, while properly addressing clinical needs and the safety of the client and the community, and providing stabilization services that assist individuals in distress without hospitalization.

TLC Philosophy: People who have a serious mental illness do better clinically when treated in the community rather than living in a state mental hospital. They get better faster and stay better longer when they receive services in their community, if these programs meet their needs, are well organized, and easily available. The closeness of family, friends, and community support aids the recovery process.

TLC Program Criteria

Any individual with a hospital stay of 90 days or more or three or more psychiatric hospitalizations within the last year may be eligible for TLC.

SAMHC patients must have a primary diagnosis of a serious mental illness, be at least 18 years of age, and agree to participate in the program. Patients who are living in a community residential care facility may also be considered to achieve the goal of greater independence. Patients' physical health will be considered to the extent that he/she does not have a serious untreated medical need. Patients in need of licensed nursing care or nursing home level of care are not eligible for TLC programs.

TLC Program Components

➢ TLC Residential and Treatment Options

Mental Health Centers have varying types of programs and services which may include one or multiple options. Programs use a case management team comprised of many different professionals such as a psychiatrist, masters level case manager, licensed registered nurse, mental health counselors and support staff, who have an intensive outreach philosophy. Treatment consists of individual counseling, group therapy, living skills, skill building activities to increase independence, and educational and vocational pursuits. Traditional services provided by local mental health centers are available for all TLC patients. Medical and dental services are arranged for based on individual needs.

Mental Health Centers have varying types of residential programs which may include one or more of below models:

Homeshare (Adult Foster Care) - A living arrangement in a community household other than with natural family members. The home is owned or rented by the Homeshare provider. One client for whom the provider receives reimbursement for expenses, lives as a member of the household. Providers are screened, trained, and participate in monthly Homeshare provider support meetings. Respite services are available for providers.

Supervised Apartments - A living arrangement in a community apartment complex with mental health center staff on site or with mental health staff available. Patients live alone or with a roommate in an apartment, and are supported by intensive/outreach case management services.

Intensive Residential Programs (IRP) - A group living arrangement for a maximum of 16 residents and managed by the local mental health center. Center staff are on site 24 hours a day to provide structured and intensive programming that meets client needs.

➢ Mixed Residential Programs

In addition to the above residential options, the following traditional options are available:

Community Residential Care Facilities - A group living arrangement licensed by DHEC and under a Memorandum of Agreement (MOA) with the mental health center. Center staff is available.

Intensive Case Management Teams - An assertive outreach treatment approach for patients in frequent crisis, or high recidivist who use the system for psychiatric or situational distress.

Independent/Family - Clients living alone, with a roommate or family in a private home, apartment, or rooming house. This residential option is available only after patients have made the transition through the programs listed above. However, these clients still require the intensive/outreach case management of the TLC staff.

TLC Goals

  • Assist patients in transition from inpatient institutions into the community 

  • Help patients remain in the community and avoid rehospitalization 

  • Reduce acute care psychiatric admissions 

  • Decrease cost of psychiatric care to agency 

  • Facilitate downsizing of the agency's long term psychiatric facilities

Client Outcomes

  • Increase level of independence and perceived quality of life

  • Decrease reliance on hospital system

  • Manage crisis without psychiatric hospitalization

Success

After entering TLC programs, patients experienced:

  • 91 percent reduction in the average number of admissions per year

  • 92 percent reduction in the number of days per admission, statistically significant improvement in patient perception of quality of life

Future

TLCs future is bright. TLC programs are expanding to provide mental health services that address psychological, residential, financial, educational, and vocational needs. DMH recognizes the benefits TLC programs offer in providing patient centered treatment and promoting individual recovery.