The Nathaniel Clinic Becomes a Certified Community Behavioral Health Clinic

In 2014, CASES established the Nathaniel Clinic as a State-licensed outpatient mental health clinic in Central Harlem. The launch of clinic-based mental health services specifically tailored to the needs of individuals impacted by the criminal legal system was an exciting, preliminary step toward realizing an ambitious vision for a community-based health center.

“Over and over again across CASES’ programs, we see individuals forced to navigate complicated service and treatment silos that often harm and traumatize as opposed to helping in a truly comprehensive, holistic manner,” Jessica Klaver, CASES’ Senior Director of Behavioral Health Services, said. “The vision was to ultimately create a true, comprehensive center for healing and wellness in a community disproportionately impacted by the criminal legal system.”

This fall, with the support of a two-year, $4 million grant from the US Substance Abuse & Mental Health Services Administration (SAMHSA), CASES is realizing that vision. This SAMHSA grant will enable the Nathaniel Clinic to become a Certified Community Behavioral Health Clinic (CCBHC), a best practice model for community health. As a CCBHC, the Nathaniel Clinic’s menu of integrated, single-site services is expanding to include primary care, substance use, family, peer, and case management services along with mental health treatment. The clinic will also have enhanced capacity to provide mobile outreach and 24/7/365 crisis intervention.

“We are thrilled and grateful for SAMHSA’s support and this opportunity to realize a truly comprehensive single-site model for community health,” Billy Green, the clinic’s Director of Practice Operations, said.

The Nathaniel Clinic is one of only two State-licensed outpatient mental health clinics in New York City specifically designed to serve people with criminal legal system involvement, and the only one with this specialization licensed to serve youth as young as 13. Features of the clinic’s forensic specialist approach include streamlined intake and assessment to ensure rapid access to care and engagement in services that do not require clients to repeatedly share information including trauma narratives as they see different clinic staff for different needs (e.g., the intake specialist, psychiatrist, and nurse). Clinicians at the Nathaniel Clinic are also sensitive to the realities that our clients often navigate stigma about mental illness and treatment, including due to past negative experiences in health care settings, and routinely experience interruptions of services caused by life events.

“The Nathaniel Clinic serves clients with unique needs,” said Lauren Roygardner, who serves as the CCBHC Evaluation Director at the Nathaniel Clinic. “Not only do most of our clients have criminal legal system involvement, but many are also unstably housed, with about 20% of clinic clients actively experiencing homelessness. Clinicians at the Nathaniel Clinic are specialized to serve clients with these unique needs without stigmatizing their experiences.”

The clinic’s enhancement as a CCBHC highlights CASES’ commitment to providing research-backed, data-driven programs and services that are continuously evolving to meet our client’s needs. As part of this commitment, over the past five years CASES has partnered with the Institute for Family Health to provide primary care onsite at the clinic to address the high rates of chronic physical health conditions experienced by individuals who have involvement in the criminal legal system. Our robust continuum of outpatient forensic behavioral health services include Health Home Care Management (HHCM), Intensive Care Management (ICM), Forensic Assertive Community Treatment and Assertive Community Treatment teams (F/ACT), and Intensive Mobile Treatment (IMT) services, in addition to primary care services.

“Primary care has proven an especially effective way to anchor clients in clinic services,” Billy explained. “There’s often less work to do convincing an individual that we can help with physical health condition, whereas that process can take longer when focusing solely on mental health.”

Promoting engagement and reducing barriers to access are key benefits of the CCBHC model. Another feature is partnering with an advisory board of clients, client family members, and community stakeholders to monitor CCBHC services, outcomes, and client experience.

“We are thrilled about all aspects of the CCBHC,” commented Shavar Chase, CASES’ Advanced Practice Clinical Director, “but the opportunity to more closely engage with clients, their families, and with community stakeholders is a further, critical step in CASES’ organization-wide priority to become more deeply integrated in the Central Harlem community.”

CASES is grateful to the US Substance Abuse & Mental Health Services Administration for its support of the Nathaniel Certified Community Behavioral Health Clinic, the nation’s first forensic-specialist CCBHC.