San Bernardino County Department of Behavioral Health • A Data for Good Story

Changing the conversation about behavioral health

San Bernardino County uses data management and advanced analytics to improve care and address misconceptions

It’s common to hear people tell a personal story about battling cancer, fighting heart disease or treating diabetes, but you rarely hear sincere dialogue about severe depression, addiction or behavioral health conditions in general.

Stigmatization of behavioral health disorders is a major obstacle to fight these health conditions. California’s San Bernardino County Department of Behavioral Health (DBH) is working to change that. Although many effective treatments and services are available, the County Mental Health Plan knows that people can feel uncomfortable or intimidated about seeking help – if they even know that assistance is available.

DBH uses SAS Data Management paired with sophisticated SAS Analytics to improve the quality of data and find insight within all this information. Now, the department can find better ways to connect people to the right type of behavioral health services – and enable them to live healthier, more satisfying lives.

Using data to improve citizens’ lives

DBH started with data about its programs and their adoption. The department’s Research and Evaluation team uses SAS to answer questions about consumer engagement with the behavioral health system in order to draw accurate conclusions and offer appropriate assistance and care.

“We need to make good decisions about the community we're serving, and the best way to do that is to collect, manage and analyze data,” said Sarah Eberhardt-Rios, Deputy Director for Program Support Services at DBH. “One of the benefits of our SAS data warehouse is the ability to bring a lot of disparate data sources together, as this helps tell a person’s story and shapes how we can assist.”

For example, the organization maps data about its consumer population and uses these maps to determine the best locations for different behavioral health services that will best meet the location needs of those they serve. Analysts can see which areas need improved access, find places they thought were underserved that actually weren’t, and see how this affects their network of providers.

Using this data, DBH began to see, among other things, patterns of re-hospitalization. The department reviewed how long people had been in care, what systems they came from, what services were used, and what services could potentially keep them out of the hospital. DBH discovered that it had preconceived notions about hospitalizations and how to connect patients to outpatient services. This insight was used to change how the department provided outreach for outpatient services, to both consumers and hospital staff.

To make these connections, SAS helps DBH identify patterns that it would not be able to otherwise detect. “We start with a question or hypothesis and mine our data warehouse for answers. If we find that our hypothesis was wrong, we ask additional questions,” Eberhardt-Rios explains. “This approach saves us months or years of manual or other types of analysis. Ultimately, we become much faster and nimbler, which means our community members are getting the health services they need quicker.”

DBH relies on analytics to guide its operations – everything from service strategy and community outreach to improving quality of care.

When focused on enhancing care, staff can look at the targets for a particular program, measure how well outcomes meet those targets, and then give that information to clinicians working with consumers so they can see individual change. “When you can show the very important work of our providers is helping people and making positive change, morale and quality of care increases,” says Eberhardt-Rios.

“SAS has given us more credibility because now the data we’re sharing is easily digestible, valuable and relatable,” she adds. “While we still have a long way to go, and many improvements are needed, the opportunity to use data in decision making for public mental health is endless, and analytics get you there.”

Shifting mindset and promoting wellness

DBH’s data analysis has helped identify barriers to care. The data has shown a different, less stigmatizing picture than many people in the field have thought.

“In the past, we’ve developed systems and business processes under the assumption that people frequently avoid care. But analytics tells us that they’re often eager to access services,” says Dr. Joshua Morgan, Chief of Behavioral Health Informatics for DBH. “We found that they’ve been knocking on our doors, but sometimes the most appropriate intervention services have been difficult to access, mostly because the array and types of services we offer aren’t widely known. If their inability to access services is due to a barrier that we have unintentionally contributed to, we work diligently to change that.” “Our greatest responsibility and commitment is to access quality care for those we serve,” adds Eberhardt-Rios.

In addition to stimulating process improvements within the department, data analysis has a wider reach. DBH shares its results with other groups, like hospitals, law enforcement, schools, community representatives and elected officials.

“The data analysis we conduct with SAS helps us promote awareness, wellness, resilience and recovery in our community,” says Morgan. “When we’ve shared our findings with our partners, they’ve been very receptive to the analysis and encouraged by the many ways we’re reaching residents of San Bernardino County – a goal we all share. Having this open dialogue helps shape outreach efforts and increases our momentum in the behavioral health movement.”