Today, we are featuring a Q&A with one of our clients, the South Carolina Department of Mental Health, to shed light on their journey with DBT and Behavioral Tech, as well as the value DBT has brought to their programs statewide. Their responses may be helpful to those who are considering DBT.
Tell us more about your role in bringing DBT training to South Carolina.
The South Carolina Department of Mental Health (SCDMH) is unique in South Carolina, because it is a provider of care, operating 16 community mental health centers (and associated clinics), five Veteran Nursing Homes, three inpatient psychiatric hospitals, an addiction treatment center, a Sexually Violent Predator Program, a Not Guilty by Reason of Insanity Outreach Clinic, Forensic Services Division, and a community nursing home. When SCDMH was awarded the SAMHSA Zero Suicide (ZS) Grant in 2018, we were able to implement Zero Suicide statewide. One initiative was to increase the number of evidence-based treatment modalities for suicide we provided in SC, and DBT helped us achieve this goal. Since launching the ZS initiative, we have funded and hosted five cohorts of DBT Intensive Training as well as one cohort of DBT for frontline staff. We also funded additional DBT related textbooks and videos for continual learning of cohort participants. These cohorts included clinicians from partner agencies to increase capacity for EBP care in our state. The final cohort will complete part 2 in August of this year.
What is the scope of evidence-based treatment provided by SCDMH?
SCDMH is a statewide organization, and all its outpatient mental health centers and inpatient facilities provide DBT treatment. From January to March of 2023, SCDMH provided evidence-based treatment to patients who were on our suicide care pathway to more than 1,500 individuals. DBT is one of the evidence-based treatments SCDMH provides to patients on this pathway.
In which ways have you engaged or worked with Behavioral Tech?
Outside of DBT Intensive Training, we have participated in webinars and continued consultation.
Why did you pursue DBT training?
SCDMH opened its first, and the state’s first, DBT program in 1992, with permission from Dr. Linehan at Columbia Area Mental Health Center (CAMHC) in response to a growing need within the Center’s patient population for evidenced-based treatment in the partial hospitalization program and outpatient clinic. The efficacy became clear early on. CAMHC’s program, 31 years later, remains the only program at the Center that has never lost a patient to suicide, either during or post treatment. In addition, hundreds of patients have gone on to live lives worth living. When it was time to select an EBP for the Agency’s Suicide Care Pathway, it was a natural decision to work on expanding DBT across our state.
How has implementing DBT impacted the hospitals and mental health centers in your state?
All SCDMH’s hospitals and outpatient mental health centers have staff intensively trained to provide DBT treatment. Leveraging the asset of a unified mental health center system with staff that have been trained in a variety of treatment settings and a comprehensive ZS approach, SCDMH has been able to reduce risk for suicide during care transitions. SCDMH elevated its approach and began including community/private partners in training cohorts to expand capacity. Because SCDMH’s mission is to support the recovery of people with mental illnesses, funding this life-saving training is a further demonstration of the Agency’s dedication to South Carolinians. Many of our partner agencies have noted that they would not have been able to obtain the training or implement it without the support of SCDMH.
What steps did you take before you started training to make the decision?
After the long-standing success with CAMHC’s DBT program, SCDMH wanted to expand effective evidence-based practices for suicidal ideation across the state. When SCDMH was awarded the SAMHSA Zero Suicide Grant, we were able to achieve this goal. South Carolina had one cohort of DBT Intensive training each year, expanding the state’s treatment for people who are struggling with suicidal ideation.
If you were advising another state considering coordinating DBT training at this level, what steps would you recommend they take? Lessons learned?
It is important for anyone pursuing DBT training at this level to research the model. Doing so will assist in determining if an agency or organization can commit the time, cost, and effort needed to implement DBT. Research can also assist in planning how to bring this level of training to the state. For example, SCDMH planned to have five cohorts of DBT over five years. This helped us build existing DBT teams, develop new teams, and strengthen DBT across our state as a whole.
What was your experience and what was most impactful?
I (Jessica Barnes, SCDMH Program Manager) completed DBT Intensive Training in 2020. When I took the training I gained more skills, confidence, and support to treat people who were having thoughts of killing themselves. The support I received from the trainers and my team helped me provide care to my patients in a way that best met their needs. I saw growth within my patients as they worked towards building lives worth living for.
This blog was authored by Jessica Barnes, Program Manager for SCDMH.
Jessica Barnes is program manager of the South Carolina Department of Mental Health’s Office of Suicide Prevention and also works the Agency’s South Carolina Mobile Crisis program as a region administrator, covering Aiken, Lexington, Orangeburg, and Richland counties. Barnes received her Bachelors of Arts degree in Psychology from the University of South Carolina and her Master of Science degree in Clinical Mental Health Counseling from Western Carolina University. She has a clinical background in suicide prevention work as a DBT-informed therapist and led the Suicide Prevention program at SCDMH’s Columbia Area Mental Health Center prior to her present position. Read more about SCDMH here.