Wraparound Services and Community-Based Supports for Mental Health Model

Some rural communities are using wraparound services and community-based supports to deliver mental health services. This is consistent with the Substance Abuse and Mental Health Services Administration (SAMHSA) definition of recovery, which states that recovery from mental health conditions happens in multiple dimensions, including one's home and community. Mental health wraparound services can include case management, counseling, medical care and health services, family services, social work, housing assistance, and dietitian assistance.

A popular community-based approach is the Clubhouse model, which is based on the belief that every member has a safe and respected space in the community. Social service organizations who adopt the model can provide structure and meaning to an individual living with a mental health condition. Those who participate also have a chance to enhance their quality of life by participating in social, occupational, and educational opportunities.

For an overview of wraparound services, see our Rural Services Integration Toolkit. To learn about addressing social factors to support substance use recovery, see our Rural Prevention and Treatment of Substance Use Disorders Toolkit.

Examples of Rural Programs Offering Wraparound Services and Community-Based Support for Mental Health

The Pathways Vermont Housing First Program addresses the needs of those experiencing homelessness by providing mental health and substance use treatment. This community-based support program is built around the Housing First model, which supports people experiencing homeless by providing housing, assistance, and other basic necessities. The goal of the program is to help individuals maintain housing, but the program offers a variety of other services, including access to mental health services and computer training.
The mission of the Rural Outreach Center (ROC) is to break the cycle of rural poverty by supporting people toward self-sufficiency. These wraparound services include counseling, play therapy, and care coordination. ROC Counseling provides support through a team of licensed mental health clinicians. Play therapy offers children with mental health conditions, trauma, behavioral problems, and family issues a way to help them grow, heal, and succeed.
The Northern Lights Clubhouse uses the Clubhouse model to provide social outlets for individuals with mental health conditions in rural communities. Northern Lights Clubhouse is based in Ely, Minnesota. It offers services including education and connection to community resources, employment and academic support, holistic wellness activities, and culinary and nutrition support.
SAMHSA funds System of Care grants to provide wraparound services for children and youth with serious emotional disturbances and their families as part of the Comprehensive Community Mental Health Services for Children and their Families Program. With their System of Care grant, North Dakota is working to expand community-based behavioral health services and supports for children with or at-risk for mental health challenges.

Implementation Considerations

Providing wraparound services requires effective coordination and sufficient resources to address mental health concerns. The ability to offer wraparound services may be limited by the availability of formal services in rural communities. Nonetheless, rural mental health programs can provide individualized support for patients by relying on and adapting community-based supports. In addition to mental health professionals and other clinical providers, rural mental health programs may engage other informal supports including family members, teachers, mentors, and other community volunteers, to assist in the provision of wraparound services.

Building strong partnerships with local organizations, community leaders, and healthcare providers is essential for effective coordination and collaboration. When implementing wraparound services and community-based supports, partners support access to resources, community buy-in and trust, collaborative problem-solving, and coordinated care.

Wraparound services and community-based supports for mental health often aim to address a patient's social determinants of health (SDOH). Rural mental health programs designed to address SDOH may be disincentivized by a fee-for-service reimbursement structure or only funded to focus on one social determinant. To learn more about funding strategies for programs that address SDOH, visit our Social Determinants of Health in Rural Communities Toolkit.

Program Clearinghouse Examples

Resources to Learn More

Implementing Wraparound in Rural Communities
Video/Multimedia
Explores strategies for serving rural communities with the same high-quality wraparound as provider-saturated urban centers.
Organization(s): Innovations Institute Technical Assistance Network
Author(s): Robshaw, S. & Strader, S.
Date: 11/2019

Wraparound as a Community Mental Health Service Philosophy for Children and Adolescents
Document
Illustrates the wraparound philosophy, an alternative for children and adolescents who are severely emotionally disturbed needing tertiary prevention care in the least restricted environment.
Author(s): Rosa-Davila, E. & Lozada, V.
Citation: Journal of Mental Health and Social Behaviour, 3(2), 147
Data: 9/2021