Continuing Care Outpatient Services Department

The Continuing Care Service (CCS) was created in 1974 to address the long-term needs of DMH priority clients within an integrated system of care. The deinstitutionalization movement necessitated the development of a comprehensive network of clinical, residential and day programs that would enable persons with mental illness to live safe, satisfying and productive lives in their communities while helping them access a full range of community resources for their treatment and rehabilitation. The CCS aims to minimize the need for psychiatric hospitalization and maximize each client’s capacity to function as effectively and independently as possible. The Service is committed to the preservation of human rights and empowerment of clients, and views client preference and choice as fundamental to a successful outcome. Efforts focus on helping clients access benefits, suitable housing, effective clinical treatment, clubhouse, vocational and rehabilitative services, and maintain natural support systems such as families, spiritual supports, self-help groups, and other generic community resources.

With some 40,000 outpatient visits per year, the CCS currently serves over 1,200 active clients with serious and persistent mental illness. Latino clinicians serve over 150 Latino clients in their native tongue. The schizophrenia spectrum accounts for the largest number of clients. Co-occurring problems include alcoholism and drug abuse, homelessness, and chronic medical problems. The Director of the Service is Barbara Lagerbom, RN, MS, CS.

The core of both the Continuing Care and Day Hospital services are the multidisciplinary teams composed of 4 – 5 staff clinicians from a variety of disciplines (social workers, nurses, masters in counseling clinicians), 1 – 2 staff psychiatrists, and a Team Leader who is a master’s level clinician. In addition, each team typically has 2 – 4 trainees, which may include resident M.D.’s at all levels of training, and psychology and social work interns. Many teams also have some combination of a staff psychologist, neuropsychological fellow, and day program and residential consultants. The team approach facilitates a collaborative understanding and care of each of the team’s clients — from the perspective of the individual clinician’s role with the client as well as from that of their colleagues’ particular experience and professional discipline. In this way, staff learn to understand their clients from a combination of biological, psychodynamic, cognitive, behavioral, family systems, psychopharmacological, and psychosocial treatment approaches, according to the particular needs of each client. Team members utilize a wide range of expert consultation that is available at MMHC to assist with diagnostic and treatment issues. A PGY-IV outpatient Chief Resident helps to provide integration between trainees and staff, and between the CCS and the Healthcare for the Homeless Service.