How It Works

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1. Admission & Assessment – Participants admitted to the RCH Behavioral Health Unit are assessed by our team. Based on their needs, they are connected with a provider, taking into account existing relationships, specialties (such as substance abuse or LGBTQIA+ care), and personal preferences.
    

2. Case Management Support – Our Case Managers and Community Health Workers assess Social Determinants of Health (SDOH), connect participants with resources, and ensure a primary care provider (PCP) is in place before discharge.
    

3. Daily Counseling – Participants receive counseling through the Mental and Emotional Health Series, providing tools to initiate the healing process.
    

4. Collaborative Care Transition – Partner agencies meet with participants during admission to ensure a smooth transition of care, with follow-up visits scheduled within 7 days of discharge.
    

5. Medication Support – Before leaving the hospital, participants are given prescribed medications with clear dosage instructions to improve adherence and recovery.
    

6. Ongoing Follow-Up – For six months post-discharge, Case Managers coordinate monthly follow-ups with partner agencies to reassess needs and ensure continuity of care.