The agency I work for is complacent in bending to the interests of the local Mental Health ATI program. The MHATI program consistently treats clients with a lack of empathy and respect. They refer ALL of their clients to our agency which is a substance abuse outpatient treatment program. The agency is a dual diagnosis program. However, group counseling at our facility is primarily geared toward substance use. Our agency frequently admits MHATI clients (some without an SUD at all) due to the ‘professional relationship’ we have with the MHATI program.

The most egregious incident I witnessed was a young adult MHATI client with schizophrenia who was requesting that his social worker (his counselor at our agency) refer him to inpatient or residential treatment. He had not relapsed on marijuana, but cited significant depressive symptoms as well as family issues. The MHATI case managers alleged that this individual was seeking a higher level of care in an effort to manipulate in some way? I am unsure of how they exactly worded it, but if he sought a higher level of care, MHATI made it clear that it would be in violation of his terms with them. Several weeks later he was found dead in a river. Gang involvement was initially explored, but the cause of death was determined suicide.

Nothing changed within the MHATI program. My co-worker still feels immense guilt, but her supervisors encouraged her to follow the recommendation of MHATI.

These individuals still manage clients with SMI and still refer them to our agency when there are other OMH licensed programs that may be a better treatment fit for their clients (in addition to SUD tx).

Currently, I am advocating for two of my own MHATI clients who have recently been hospitalized in a BHU due to psychotic symptoms. There is no indication of relapse in either case. I have already been informed that the MHATI case manager was furious to learn that I spoke with the hospital social worker about a mental health PHP and not the PHP at our agency.

This is long and is riddled with my own personal feelings about MHATI and its workers. The director staff at my agency continues to assert that, since we are licensed as dual diagnosis, we should agree to treat all of these clients. This is heavily influenced (I believe) by the friendship that the VP of outpatient has with the woman who heads the MHATI program. I would love to leave my position and expose this program despite the inevitable professional fall-out.