Episode 9: A Conversation with Behavioral Health System Baltimore (BHSB)

211 Maryland speaks with the leadership of Behavioral Health System Baltimore (BHSB) about mental health services and support in Baltimore City.

Show Notes

Click on the show note section to jump to that part of the transcript.

1:18 About Behavioral Health System Baltimore (BHSB)

Learn about BHSB and the ways they’re supporting the community’s mental health needs.

3:14 Improving Schoool Behavioral Support

BHSB works with schools to give families and children access to the mental health support they need.

5:24 Harm reduction work

BHSB has an outreach and training program to support the community’s needs, specifically around drug use. The Maryland Harm Reduction Training Institute provides optimal support for people who use drugs and Bmore-Power is a grassrooms group that provides street outreach and Naloxone information.

6:48 Mental health needs of the community

Mental health impacts everyone in the community. BHSB talks about how its identifying gaps in behavioral health and improving those.

9:25 Reducing police interaction and overreliance on emergency rooms

BHSB launched the Greater Baltimore Regional Integrated Crisis System (GBRICS) Partnerhship to transform mental health services. The goal is to reduce unnecessary emergency room visits and law enforcement interactions.

11:57 Impact of COVID-19 on mental health

While COVID-19 challenged the city like other communities, positive mental health support evolved from it.

14:37 Diverting 911 suicide calls to emergency mental health support

When a suicide call comes into 911, BHSB is working to divert those calls to their hotline through a pilot program. Learn how it works.

16:09 Accessing mental health support

Learn how to access mental health support in Baltimore City.

17:32 Future of mental health support
If BCBS had a magic wand, what would mental health support look like?


Quinton Askew, 211 Maryland

Good morning, everyone. And welcome to What’s the 211? podcast, where we share information about information and resources that are going on in your community. So today, we have our special guests joining us. Adrienne Breidenstine, Vice President of Policy and Communications and Stacey Jefferson, Director of Policy and Stakeholder Engagement at Behavioral Health Systems, Baltimore.

So just want to get into with a couple of questions and really jump right in. So can you just tell us a little bit about Behavioral Health Systems Baltimore and really the role that it’s playing in the city?

What Is Behavioral Health System Baltimore, And How Do They Support The Community?

Adrienne Breidenstine, Vice President of Policy and Communications at BHS Baltimore (1:18)

Sure. So. for those who don’t know us Behavioral Health System Baltimore is a nonprofit that serves as the local behavioral health authority for Baltimore City.

So in this role, we support a full range of prevention, early intervention treatment, and rehabilitation and recovery support for the city of Baltimore. Part of our role is also to promote access to the full range of mental health and substance use services. And we do this by promoting access work through a variety of different partnerships with system advocates, with system stakeholders, including, you know, the Baltimore City Mayor’s Office, law enforcement systems, the school partners, but also at a grassroots level with our community engagement work.

Another important part of our role is advocacy. We know that if we are going to promote access to the system of care and high-quality mental health and substance use services that advocacy at the state level and also at the local level is core to our work and its core to promoting our values of collaboration and equity, for example. So that’s another big part of what we do.

Quinton Askew (2:24)

Okay. So it sounds like a lot of the work is really around collaboration coordination, bringing folks together within the city with a focus on mental health and so then there was a lot of community involvement as well.

Adrienne Breidenstine (2:35)

Yes. And Stacy could talk a lot about what our community engagement work is.

Stacey Jefferson

Yes. So we definitely have expanded over the past year and a half our community engagement, where we go out into the community and share information about resources, but we also talk to communities about what services and things they would like to see. They also help to inform where we go as far as system changes as well.

And so we really have tried to bring in the community and engage with the community to get a better understanding of what the community is looking for as far as continuing to provide services for our emotional health and wellness.

Improving School Behavioral Health Support

Quinton Askew (3:14)

Okay. And so just for audience purposes, I’m going to use acronyms here at BHSB to really describe the Behavioral Health Systems of Baltimore. But we know that you all are really extremely active in advocating for policies really to address mental health. 2021 priorities focused on strengthening, expanding Behavioral Health Crisis Services, but also increasing school behavioral health supports. Why was this important to the organization?

Stacey Jefferson (3:38)

So those particular policies were really important as again, crisis is really an access point to the system. And it also, as we know, is really important as far as our equity work as well. And as much as we realize that we do have services in the city, we want to make sure that people are accessing them immediately when they need them. And so our crisis advocacy work was important to that, but then also our work, as far as school behavioral health services, because that’s another access point, especially for our youth and our families. And so we wanted to make sure that those services continue to be available, but also expanded and accessible to everyone who is again in the school system and be able to access that service.

Quinton Askew (4:29)

Yeah. Elaborate with what the school systems do. Now, do you see more students trying to have access or better access for students within the school system?

Stacey Jefferson (4:48)

I would say that there has been a lot of time, particularly with COVID recognizing the importance of the services for youth and ensuring that they have access to it. Realizing a lot of the things out of COVID that youth have been experiencing such as isolation and, you know, just really caring about their emotional health during this time.

And, so we have seen that people are more willing to have those conversations, but then also recognizing how important it is that we ensure that those services are available in schools.

Maryland Harm Reduction Training Institute And Bmore-Power

Quinton Askew (5:24)

Okay. And so that’s definitely good. And we know that you all provide a lot of community support and training for other nonprofits and organizations. Can you share a little more about what your Maryland Harm Reduction Training Institute is and Bmore-Power?

Stacey Jefferson (5:39)

So that’s part of our larger harm reduction work that we do at BHSB. We are again, really committed to that work.

And so Bmore-Power and both our Maryland Harm Reduction Training Institute represent our outreach and training portion of our harm reduction work. And so Bmore-Power as a grassroots harm reduction group. They provide street outreach resources and Naloxone information to the community.

And then we have the Maryland Harm Reduction Training Institute that really aims to develop the Maryland Harm Reduction Workforce and Support programs and providing, making sure that they’re providing optimal services for people who use drugs. And they really do this through like technical assistance and training, particularly for like various audiences, like people who use drugs, overdose, response programs, and syringe service programs throughout.

Quinton Askew (6:33)

Okay. And who can sort of benefit from these technical trainings?

Stacey Jefferson (6:37)

Again, a lot of these trainings are for people who are providing services for persons who use drugs. And so that’s really who can benefit a lot from it.

Mental Health Needs Of The Community

Quinton Askew (6:48)

Okay. And so I, I read on your site that, you know, some stats around behavioral health, which was really alarming. That one in five people have a mental illness and one in ten people have a substance use disorder. So we know that, you know, BHSB is charged with managing the system of care in a city. Like how have you all seen the need for behavioral health services evolve and really are there still gaps with some of the work that’s going on?

Adrienne Breidenstine (7:11)

You know, the statistics show, I think at least for me, how mental health and substance use is really something that affects everyone in our community. We see it in our communities. We see it in our own families. We see it with our other loved ones in terms of need.

The public Behavioral Health System in Baltimore serves over 78,000 individuals annually. And we are the largest share of the public Behavioral Health System for the state of Maryland, roughly around 35% of that larger or statewide public Behavioral Health System.

I tend to think in Maryland that we do have a good public Behavioral Health System in terms of there is a broad array of services available to people. We talked about this earlier, right? We have prevention early intervention treatment, recovery support services. Our role is really trying to promote access, but we also recognize that there are some gaps within our system of care.

Adrienne Breidenstine (8:05)

One of the things that BHSB supported, Baltimore City on was, doing a Gap Analysis a couple of years ago in 2019. We released a Gap Analysis of the public Behavioral Health System that provided 38 recommendations for how we could better improve the public Behavioral Health System.

In Baltimore, this Gap Analysis is actually a really helpful tool that the city and BHSB and the police department are using to help prioritize how they approach addressing some of the behavioral health findings in the Baltimore City consent decree.

One of the areas that we are prioritizing is improving and enhancing Behavioral Health crisis services. We’re also looking at expanding access to peer support, and the city is looking at how they can also expand access to safe, affordable housing.

But we know we need more peer support. We need more recovery, wellness and recovery centers because they are again at a grassroots level and access point. They’re also a place that we know many people go to when they are experiencing distress or some kind of crisis.

So, when we think about gaps in our service system, those are behavioral crisis services. And our peer support services are kind of the two big ones that we prioritize and think that we prioritize and that we put our advocacy behind that, but also try to bring in more resources to support those services.

Reducing Police Interaction And Overreliance On Emergency Rooms For Behavioral Health Calls

Quinton Askew (9:25)

Yeah. And speaking of resources and really helping to coordinate and, and fill those gaps, you know, back in November 2020, we learned about the Greater Baltimore Regional Integrated Crisis System (GBRICS) Partnership, which is really that innovative partnership that will hopefully transform how mental health services are provided. Can you talk a little bit about that GBRICS Project, what that is, and sort of some goals with that in Central Maryland?

Adrienne Breidenstine (9:46)

I’m glad you brought that up because that is a really exciting project that we are looking at to help address some of those gaps within the Behavioral Health crisis services system. So GBRICS stands for Greater Baltimore Regional Integrated Crisis System partnership. And it’s a public-private partnership between 17 hospitals and Behavioral Health System Baltimore.

The goal of this partnership is to reduce unnecessary EDU and law enforcement interaction for people who are experiencing crisis. Over the course of five years, we will invest $45 million in behavioral health infrastructure and certain services in Baltimore City, Baltimore County, Carroll County, and Howard County.

So this project takes us a little outside of our traditional jurisdictional roles in that we are partnering with three other jurisdictions to expand access to these types of services.

Quinton Askew (10:43)

Interesting. That’s really interesting. And so, you know, bringing all of these entities together, sort of around sort of a common goal, did you find that easier to do because it’s sort of that common goal or was it more sort of, you know, mental health is different at each jurisdiction?

Adrienne Breidenstine (10:57)

For this particular project, there was a lot of buy-in early on. I think a lot of people recognize that there is a need for behavioral health crisis services. Like Stacy mentioned earlier, the behavioral health crisis system is one of the largest access points to that broader system of care. So, you know, when we were initially approaching this project, it had a lot of interest because there’s a lot of need to build out these services. And there’s a lot of gaps across the four jurisdictions and across the state, there’s a lot of attention on behavioral health crisis services right now for a variety of reasons, right?

There’s the ongoing COVID pandemic that has placed more pressure on our communities and increased the need for services. There’s all this work to look at how we can redirect resources and redirect police resources away from involving them in addressing the crisis.

So, there’s a lot of attention on this issue right now that’s good attention. It’s finally the attention I think it deserves.

Impact Of COVID On Mental Health

Quinton Askew (11:57)

Definitely looking forward to it getting off the ground. So, you know, you mentioned COVID earlier. So, we witnessed several traumatic events this past year. Since the COVID numbers are going up again, unfortunately, has the demand for services really increased in specific communities within the city, or with the demand on your organization, organizations reaching out to say, hey, we need more help. Like what, what else can you do for us?

Adrienne Breidenstine (12:24)

Well, we have seen an increase. So we’ve seen a couple of things. We’ve seen an increase in the number of calls that come to the city’s 24/7 Here2Help Hotline. There’s been an over a hundred percent increase since April of last year. And the call volume has remained relatively high.

[Editor’s Note: You can also call or text 988 if you need to talk. You’ll be connected with the Suicide & Crisis Lifeline.]

So, we know more people are calling and calling our hotline with hopes of accessing services. So that’s one kind of data point that we use that shows us that there’s a need and an increased need.

We also know that our providers are seeing people coming in with more acute needs. Again, some of this is because of the social isolation and the loss and grief that our community at large has experienced as a result of COVID.

And also, in Baltimore City, we know that violence and systemic racism is another issue that has long been driving the demand for behavioral health needs resources in our community, but to COVID, providers have been able to adapt.

Adrienne Breidenstine (13:18)

One of the ways they’ve been able to adapt is through the use of telehealth that has allowed them to continue to engage with clients, but then also expand access to their services throughout the community because people can’t connect with their provider from their home using their phone.

So, that is one of the other things that is probably a positive policy change and a service delivery change that has happened as a result of COVID.

And then the final thing that we did, and we’ve been doing this even before COVID is promoting ways for that anybody can take care of their emotional health and wellness. There are things we can do in our everyday life to support our mental health.

So, we have partnered with the Baltimore City Health Department and the Mayor’s Office to be promoting tips for how you can take care of your overall mental health and well-being.

Quinton Askew (14:15)

That’s great. And even with, with staff, you know, have you seen staff really need more support you know to get more support with the work that they’re doing, because again, they’re in the trenches every day with providing this access to services.

Adrienne Breidenstine (14:28)

I mean, I think our entire healthcare industry is feeling some burnout as a result of the pandemic.

Diverting 911 Suicide Calls To Emergency Mental Health Support

Quinton Askew (14:37)

So, Baltimore City is taking really another innovative approach to mental health by piloting the city-wide 911 diversion program. And so, you know, is there any information that you can share a little bit about that? You know, what impact that might have in the city, the roles of mental health providers, how that will affect Baltimore City residents?

Adrienne Breidenstine (14:57)

So like you said, it’s a pilot program. The 911 diversion program is taking certain types of behavior health calls that come to 911 and diverting them to the city’s Here2Help Hotline. So, as we said again, the pilot is  very small and its initial stage.

The types of calls that are being diverted are suicide calls. So people who are calling experienced suicidal ideation. Those calls are being screened by 911. And if they meet that certain criteria and they are being transferred to the Here2Help Hotline.

All of this, this diversion pilot, has all come out of the work the city has been doing to address the behavioral health findings in the consent decree. Their ultimate goal is to reduce police interaction with people who are having behavioral health crises.

So, diverting suicide calls to Here2Help Hotline is just one step in that kind of broader effort to divert more calls that come to 911 to the Here2Help Hotline. It’s a little data point. The city’s 911 call center gets over 13,000 behavioral health calls annually. So we’re looking to try to divert as many of those as possible to our system of care. And that’s why our partnership with law enforcement is.

Accessing Mental Health Support

Quinton Askew (16:09)

That is definitely important just to make sure really the calls get to where they need to get to. How can individuals in the city easily access mental health services? Are there specific ways that can provide quick access?

Stacey Jefferson (16:24)

So, the best way for people to access is the Here2Help Hotline. And there is a 24/7 line that provides access to confidential advice and emotional support. And then the number for the Here2Help Hotline is 410-433-5175.

Editor’s Note: If you live outside Baltimore City, you can call or text 988, for behavioral health support.

Quinton Askew (16:46)

And so you said, again, it’s 24/7. And so, with all the great work that the BHSB s doing, are there other ways that individuals can connect, learn more about all the work that you’re doing? Any, any social media or website that you can share?

Stacey Jefferson (17:03)

Yes, definitely people can learn more about us. They can follow us on social media, TwitterFacebook, and Instagram, and BHSB to keep updated on our work and resources. And then also you can go to our website. Our website is https://www.bhsbaltimore.org/. And also we have a newsletter. So if you go to our website and gold scroll to the bottom, it has a place for you to sign up for our newsletter as well.

The Future Of Mental Health Services And Support In Baltimore City

Quinton Askew (17:32)

That’s good. And so, you know, just one last question. So, you know, the mental health services and behavioral health services in Baltimore in the city, if you had a magic wand for easy access or to ensure, you know, that all the services were provided in a certain way or accessible in certain ways, know anything specific that would be of great use of how folks can access or just where you would like to see mental health services go in the future?

Stacey Jefferson (17:58)

I’ll take a stab. One thing I’ll say is that there actually be no one point where people had to access services, that mental health services are readily available and treated a lot like physical health have that same type of accessibility.

Quinton Askew (18:16)

And so now that that’s a great point that you mentioned that and, you know, with all the work that you all are doing, as far as coordinating those services, I think that’s really the avenue that is going in the city where it’s more of a coordination. It’s really no wrong door for someone to get help when they need it and where they need it.

One other question, do you see any sort of disparities in the data? Is there is a particular age group that might be reaching out for help more than others? Our younger age group, do they seek help in a different way? Do you think the older adult population is seeking help in different ways?

Adrienne Breidenstine (18:44)

Yes. The short answer is yes. Youth and adults engage with the system differently to piggyback on your last question about what else and what more we could do. I think we need to be doing a heck of a lot more to take care of our youth. And some of that starts at the grassroots level in the community where people live and it feels safe, but we need a lot more resources to help support the youth in our community and not necessarily traditional what we might think of as traditional behavioral health services, like outpatient services. So that’s why I say services that are in the community that meet youth where they are and provide the care in ways that youth want to engage.

Quinton Askew (19:23)

That’s great. And so I definitely want to thank both of you again for coming on and joining us here. It was great. Definitely look forward to working with you in the future. Appreciate the work you all are doing.

Thank you for listening and subscribing to “What’s The 211?” podcast. We are here for you 24/7/365 days a year simply by calling 2-1-1.

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