The Community Centered Solutions grantees we’ve supported over the last five years have most often been grassroots organizations that are deeply embedded and trusted in their own cultural communities. They know the strengths and challenges of their community first-hand and are working hard to be responsive to the needs their communities have identified. These organizations prioritize access to care, cultural relevance, and personal connection as important ingredients for wellness. In addition, many are supporting care providers, caregivers, and peers with the resources and training they need to take care of their own health and healing while providing high quality services to Denver’s residents.
Each year, we have a learning conversation with each grantee to create space for reflection on their progress and impact for the year and to hear about what it takes to make a positive difference in addressing behavioral health needs for Denver. These insights inform our own learning conversations within the Foundation to help drive our strategy. We do this because learning isn’t actually learning unless it drives you towards your best next steps. We are sharing these grantee insights, and our actions, because they belong to this community-particularly the grantees who provided this information and Denver’s taxpayers who make this work possible.
Grantee Reporting
Caring for Denver currently supports community centered solutions grantees in their efforts to develop, implement, and improve care for Denverites. Each year, these grantees track the number of Denverites served, the types of care provided, and also choose “signals of progress” and/or “shared impacts” to measure and report on at the end of the grant year. Grantees can prioritize what signals to report based on what aligns best with their program’s intended outcomes and we work with them to choose measures that align with their capacity and interests. We don’t expect grantees to measure everything they do because we respect that they have real-world work to get done. We hope our model encourages grantees to get excited about exploring their impact and creates space for reflection, learning, and sharing in ways that helps both of us do our jobs better.
Key Data Insights
Grantee Progress and Impact
In our work with community we continue to hear that increasing access, improving the fit of care, and supporting people in their care over time are key factors to address in order to see change around mental health and substance misuse in Denver. Our Community Centered Solutions grantees are doing just that. The numbers and stories below reflect data collected from our 2023 grant year cycle (November 2022-November 2023)
Increasing Access To Care
Through Caring for Denver funds, CCS grantees reported successfully helping:
- almost 7,000 Denverites engage or stay in behavioral health related care,
- over 7,800 Denverites reduce isolation and increase connections to others in ways that support wellbeing,
- over 1,300 caregivers and clients build skills and awareness to address behavioral health needs
- almost 700 people increase and use resilience and coping skills to help address challenges they are facing in the real world.
Grantee Example: Catholic Charities received grant funding to provide behavioral health assessment, treatment, and on-site care management services for persons experiencing homelessness who seek supports at Samaritan House in downtown Denver. During their last grant year, 88%-93% of clients that engaged in their clinical services reported a reduction in their anxiety or depression symptoms. Staff told us some of the credit for this success is actually what happens outside of therapy. Staff who provide therapeutic care also purposively spend time looking for informal opportunities to build connections with clients in ways that can build trust and openness to clinical support:
“Accessibility on site is something we’re realizing as critical…You have to be in their world…we join them for lunch, check in while they are outside, etc. versus expecting them to come to us. We just sit and ask, “how has your day been?”. This population has considerable stigma around mental health help and most have had trauma experiences. We have to be the ones to engage in the day to day and do heavy outreach. We have to build trust and provide informal therapeutic support to get the buy-in for longer term and more formal care engagement”
Improving the Fit of Care
Grantees also helped to address barriers to care, and reported successfully helping:
- over 5,400 Denverites engage in care for the first time, increase their ability to support themselves or others in harm reduction, or increase their comfort and trust in engaging with a care system
- almost 200 care providers reported that funding had helped to increase their ability and/or motivations to stay in their roles, and with feeling more valued and respected
- almost 300 people (including many care staff) reporting reducing their stigma around behavioral health through awareness activities and trainings.
Grantee Example: Voluntad provides human trafficking survivors with supports that address complex trauma in ways that increase stability, improve mental health, and reduce substance misuse. For survivors, trauma and stigma can create challenges to participating in formal, traditional care options. Voluntad’s bilingual staff provide intensive case management and culturally responsive clinical care, including group supports, to help clients feel a sense of community and reduce stigma around their experiences. The clients reported being positively impacted by seeing and hearing the resilience of others who have similar life experiences and feeling validated within the group. With their ability to provide care with a focus on “fit”, 96% of survivors who came through Voluntad’s door once returned to engage in additional care.
Supporting Care Over Time
Grantees reported successfully supporting over 3,200 Denverites with finding acute care, staying in care or returning to care as their needs changed, or building skills and resources to help with maintaining recovery while living in Denver communities.
Grantee Example: The collaborative model of the Rose Andom Center brings together 7 government and 16 community-based organizations in one building to meet the complex needs of domestic violence victims and their children. Over the last several years Rose Andom has utilized Caring For Denver funding to improve and streamline a culture of mental health and substance misuse response within this collaboration. Through cross-staff trainings, integrated screenings, and targeted referral processes they are helping domestic violence victims find, use, and heal through behavioral health care over time. While clients may find it hard to focus on behavioral health initially, their approach and offerings help lead clients back to mental health supports when the timing is right.
“Victims may initially disclose a need for behavioral health services, and not follow through with the connection to those services until months later. We are seeing many victims that are struggling with securing basic needs such as housing or employment, before they are able to focus on getting connected with mental health services. However, through having had a conversation during their initial intake or with the case manager where behavioral health issues were normalized and de-stigmatized they know that services are available through the Rose Andom Center once they are ready to re-engage.”
Reducing Substance Misuse/Improving Mental Health Directly
The successes above help show how Denver grantees are significantly contributing to helping people deal with the complexity of behavioral health. We know not everyone is ready to directly address mental health or substance misuse, and that the work done to help people find and accept care as well as the work done to support people in sustaining positive behavioral health after care is a significant part of the puzzle. We celebrate the successes mentioned above and all the hard work our grantees do.
We also have grantees that offer services to directly impact mental health and substance misuse. These grantees often provide care in more formal ways, for example clinical therapy, residential treatment, and sober living facilities. These grantees are more likely to be able to collect data that can show reductions in mental health symptomology or adherence to recovery plans and reduced or no use of substances. These grantees reported over 2,100 Denverites improving mental health symptoms and over 880 Denverites reducing use or abstaining from use of substances as a result of their work during the grant year.
What grantees told us about effective community-based work
Addressing mental health and substance misuse isn’t an easy task. The challenges are multifaceted, and no solution fits all needs. We’re listening to better understand what conditions and strategies seem to be making a difference right now, and what it takes to support those solutions in Denver. Grantees shared the following key insights with us:
Increasing Access to Care
| Identify needs from multiple lenses & time points Providing screenings, supportive intake assessments, and revisiting assessments over time can identify needs and initiate the right care more quickly. It helps when people across multiple roles, including administrative roles, are seen as part of the care team and are able to contribute to identifying care needs. | Connect ‘between’ for better engagement Offer opportunities for informal touchpoints, drop in flexibility, and build care models that support people who may need many touches before they are ready to engage in care. These approaches can be particularly important for people with severe and/or multiple behavioral health needs. |
| Strengthen care “webs” inside and out Referrals are critical, both internally and externally. For better internal referrals, diverse staff roles across organizations can be trained with knowledge, language, and skills to be responsive and help triage issues. Externally, staff with more knowledge and connection to referral sources can support more successful care transitions. | |
Improved Fit of Care Provided
| Shared experiences can create “safer” spaces People often engage over shared experiences more than a general curriculum topic. Creating safe conditions for people to speak up and share lived experience can increase comfort, engagement, and reduce stigma. | Language Makes a Difference Accepting, strengths-based language leads to more engagement. Framing supports to be healing centered vs. treatment centered works best. (i.e. “experiencing” vs. “suffering from”) |
| Strategies that respond and adapt meet needs Working with participants and peers to drive the types of groups and content offered keeps people motivated and coming back. | Care Providers Need Care Too Staff seek and thrive in environments where comparable pay and wellness culture are prioritized. This includes regular opportunities for check-ins and support for ongoing recovery, and wellness culture promoted as much by leadership as billable hours. |
Better Care Over Time
| Open doors keep people in care Accessible care is often circular, not linear People often want to engage longer than planned with programs they trust. Creating space and opportunities for circling back can create opportunities for deeper, sustained healing | Ensure connection back to community When providers connect people back to community supports after, or alongside, therapy, people are more likely to continue healing. Providers who follow up and/or connect at transition points can also help ensure longer lasting change. |
What we learned from CCS grantee conversations
In September, we facilitated an internal staff conversation to review and discuss the CCS grantee feedback above. While we lifted up many insights, together we landed on this key learning that we hope to prioritize in our next grantmaking cycle:
How you do something matters just as much as what you do.
Organizations approaching their behavioral health work with a focus on building and maintaining relationships often have more success engaging and retaining people in care. And good care requires a “through line” that can provide relational support across all points in the care cycle. For example,
- Screenings and Intakes require people involved to have the right training, knowledge, skills, and resources to assess and triage clients with intention and care.
- Intentional services go beyond simply adding a mental health or substance misuse component to existing work. When adding or enhancing a mental health/substance misuse support, it needs to be explicitly responding to a recognized community need.
- Aftercare options help healing stick. Programs with opportunities for participants and clients to circle back when needed, re-engage with staff and people they have built trust in, and/or give back to the programs they’ve completed help people stay engaged in healing and recovery. This is especially true for vulnerable populations and for those dealing with substance misuse.
- Community wellness options are where long-term healing can happen. When people engage in formal clinical care they learn skills and work through challenges. The long-term healing comes when they are able to utilize what they have learned and it is positively taking root in their day to day lives. Supporting the transition from formal care to community care is a critical piece of the puzzle.
- Caring for providers can be particularly important when programs prioritize relational interventions. When providers, peers, and staff carry out human-centered work focused on the things noted above, it can carry more burden and vicarious trauma. Taking care of caretakers’ behavioral health needs is vital for having impactful behavioral health supports in Denver.
What We’re Doing Next
In November, our Board will approve our next round of Community Centered Solutions grantees. As part of this process, our staff will take these learnings-coupled with learnings from our community reviewers and many other community members at large-into the Board room for review, reflection, and dialogue to ensure our grantees’ and communities’ expertise is part of decision making.
After this meeting, we’ll take time internally to review decisions made as well as the things that both helped and hindered our ability to lift up community voice in our grantmaking decisions. We’ll circle back with another post to provide those learnings to the community and lay out our next course of action for ensuring these tax dollars are going to and for the things community most wants and needs.