The goal is to facilitate integrated medical and mental health care.

By William K. Alcorn


More-efficient and potentially better health care for adults and children is at the heart of a plan to integrate current, stand-alone physical and mental-health care facilities in Mahoning County.

One Health Ohio, based at the Youngstown Community Health Clinic on Wick Avenue, and Turning Point Counseling Services and D&E Counseling Services, two core agencies funded by the Mahoning County Board of Health, say they are deep into making the integration a reality.

The concept of integrating medical and mental health in one facility is not new.

“We’ve had a satellite clinic in Valley Counseling in Trumbull County; we have a long- standing relationship with the Trumbull County Mental Health and Recovery Board, and Turning Point has a physician we placed at its facility,” noted Dr. Ronald Dwinnells, One Health Ohio chief executive officer.

“But the step we haven’t taken, and what is being planned, is to build a new one-stop medical facility in close proximity to existing mental-health facilities,” said Dr. Dwinnells, architect of the medical- integration plan.

Turning Point Counseling, which provides behavioral-health care and substance-abuse services for adults, is at 611 Belmont Ave. Immediately north across a parking lot is D&E Counseling Center, a mental-health center that provides behavioral-health services to children, adolescents and their families.

In between the two, One Health Ohio plans to build a $1 million to $1.5 million, 6,000- to 8,000-square-foot medical clinic that will provide primary medical care, dental care, health screening, a pharmacy and other medical services.

If all goes well, Dr. Dwinnells said he hopes construction will begin this summer and the structure will be ready for occupancy in late 2013 or early 2014.

One Health Ohio is a Federally Qualified Health Center (FQHC) that receives a federal grant partially to subsidize the clinical program that provides health services (a health-care safety net) for uninsured and underserved populations such as in Youngstown and Warren.

However, Dr. Dwinnells said, there will be no federal money used in this project.

“We feel it is important enough to stick our necks out and do this. We believe that over time, fees from additional patients generated by the project will pay off the cost,” he said.

Because of his business and medical background, Dr. Dwinnells said he understands both sides of the equation.

“Integrated health care is economically feasible and medically beneficial to patients. And from a medical and administrative perspective, it makes so much sense,” he said.

The other partners in the enterprise, Joseph A. Sylvester, Turning Point executive director; Gregory Cvetkovic, president and executive director of D&E Counseling; and Ronald Marian, director of the Mahoning County Mental Health Board, are enthusiastic about developing integrated medical and mental-health care with One Health Ohio.

Studies show that a person with a severe and persistent mental disorder who doesn’t receive primary health care lives 25 fewer years than a person who receives primary health care, Sylvester said.

“Now that we know that, we would be remiss by not providing primary medical care to mental-health patients. We would not be fulfilling our mission if we ignore that,” he said.

With one-stop mental and medical health care shopping, patients are more likely to be referred between the two and, with the close proximity, more likely to get the treatment they need, Sylvester said.

“We are excited about the possibility of this happening,” said D&E’s Cvetkovic.

“We want to do what we can to make this ‘down-the- hall’ connection happen because of the potential benefit of improving our success treating adolescents, children and their families,” he said.

Cvetkovic said he sees the integrated-care model as one that allows the three organizations to continue to focus on doing what they do best, but when a patient has a need not available at the agency, it can be provided in an integrated, centralized campus.

Sylvester and Cvetkovic noted that there is easy access to all the services because there is a Western Reserve Transit Authority bus stop on Belmont Avenue in front of their facilities.

Dr. Dwinnells said his board and those of D&E and Turning Point, as well as Ohio Department of Mental Health officials, are positive about its becoming a reality.

The ODMH, which holds the mortgage on the parcel where the medical clinic would be built, likely would not object as long as the use of the property adds to behavioral-health care, said Trudy Sharp, ODMH spokeswoman.

Regarding the concept of integrated medical and mental-health care, Sharp said ODMH supports it because it leads to better health outcomes.

There are other organizations that have tried this, but not on this scale.

It is not unusual for medical facilities, such as hospitals, to have mental-health units, nor is it unheard of for behavioral-health facilities to have medical components, said Marian.

But, he said, there is only one other such medical/mental-health care integration, as proposed by One Ohio Health, in the state.

“We think it’s exciting and great for our community and the Mahoning Valley,” Marian said.

The local integrative health-care project already has produced a research program, and Dr. Dwinnells predicted it will attract more as it develops.

One Health Ohio, in partnership with Northeast Ohio Medical University and Kent State University’s College of Public Health, plans to look at the effectiveness of these types of programs, he said.

“If we can prove we are saving lives and money by improving our diagnostic capabilities and by referring on a more-appropriate and timely basis, we could continue to expand our efforts improving the quality of life for many of our citizens,” Dr. Dwinnells said.

“Medicine has been fractionalized by specialization. Let’s bring medical care back together and get back to the basics of wellness and good overall health care,” he said.

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