Systemwide change in behavioral health care is possible when communities invest in learning and collaboration. In Middlesex County, New Jersey, collaboration transformed how stakeholders across the county — including those from schools, the justice system, and provider organizations— support the behavioral health needs of community members. Following a Behavioral Health Roundtable in May 2023 attended by New Jersey Governor Phil Murphy and other state and county leaders, stakeholders in Middlesex County were eager to identify opportunities to better address local behavioral health needs. This momentum led to the development of the Middlesex County Behavioral Health Partnership, spearheaded by local leaders from the county’s Department of Community Services, Office of Human Services.
The Center for Health Care Strategies (CHCS) has been partnering with Middlesex County officials to convene a diverse range of cross-sector partners for information sharing and problem-solving through the Middlesex County Behavioral Health Partnership. The initiative features virtual and in-person convenings, with monthly sessions addressing behavioral health and well-being topics across the lifespan. Topics have included, for example, harm reduction for substance use; behavioral health care for youth and families; supports for justice-involved populations; maternal mental health and substance use recovery services; behavioral health supports for aging populations; and crisis response for people with intellectual/developmental disabilities.
This blog post shares lessons from the Middlesex County Behavioral Health Partnership, offering insights for other local governments and behavioral health stakeholders interested in creating similar community-led initiatives to enhance behavioral health services.
Key Ingredients for a Community-Focused Behavioral Health Collaboration
Stakeholders from across Middlesex County gathered for the monthly sessions, which consistently attracted an average of 60 participants. Below are the key ingredients that contributed to the success of this unique county-level collaboration.
1. Create a Forum for Cross-Sector Connections and Facilitate Peer Exchange
Stakeholders were eager to connect with cross-sector partners and learn from each other to improve the behavioral health supports available in their communities. Diverse groups of stakeholders participated in each session, even when the behavioral health topic was outside of their immediate area of focus or influence. For instance, child welfare and law enforcement professionals attended sessions on harm reduction, and school counselors attended sessions on the justice system. This gave stakeholders a unique opportunity to connect with partners across sectors — facilitating mutual understanding of their shared challenges and goals. As one participant shared, “We have different perspectives, but the same overall goal [to serve our community].” Attendees emphasized that they were eager to share what they learned at the sessions with their colleagues and apply new insights to support their community and those who need help.
One compelling outcome of the Behavioral Health Partnership was the creation of a pilot program aimed at increasing access to low-barrier buprenorphine for Middlesex County residents with opioid use disorder. This collaborative effort emerged from a connection made at the Partnership’s first in-person convening, bringing together New Hope Integrated Behavioral Health Care, the New Jersey Harm Reduction Coalition, and Middlesex County’s Division of Behavioral Health Planning. In a full circle moment one-year later, representatives from all three organizations returned to another in-person convening to share insights and successes from their collaborative pilot.
2. Build Awareness and Share Local Resources
Providing educational forums for stakeholders was an early priority of the Behavioral Health Partnership. Monthly convenings featured speakers from the local community and across the state, increasing awareness of available behavioral health resources. In one session, Demystifying NJ 211, 988, and 911, experts explained the differences between these hotlines and how they work together. Attendees gained the knowledge necessary to guide the community on how and when to call each number.
To supplement the convenings, the Behavioral Health Partnership offered an online resource and discussion forum where stakeholders could ask questions and request information from peers between convenings. These tools increased participants’ understanding of available local resources — one stakeholder shared, “I am in awe of the knowledge and programs available in our community.” Most importantly, participants felt better equipped to serve their communities. This demonstrates that creating forums for behavioral health stakeholders to connect with each other can be a good first step in addressing access issues. While broader issues like workforce shortages and system complexity still require additional investment, the Behavioral Health Partnership showed that some solutions may already be within reach.
3. Center Lived Experience
Integrating the perspectives of individuals with lived experience into presentations and panels at the convenings helped ground participants in the real-life challenges and priorities faced by individuals with behavioral health needs. Families shared how services and supports, such as those available through the Children’s System of Care, helped their family gain stability. Listening to these perspectives gave participants opportunities for reflection and growth in their knowledge base. Participants actively engaged in dialogue that showed their willingness to acknowledge community members’ perspectives and adjust their approach accordingly. Participants were especially interested in topics related to harm reduction, the justice system, and addressing behavioral health in schools, and discussed opportunities for improving well-being over punitive approaches.
By centering lived experience, participants also discussedthe need to recognize stigma and the importance of working together to reduce stigma as a barrier to care. For example, the county promoted its Campaign to End Stigma, and participants identified a need to reduce stigmatizing language among providers.
4. Understand the Role of Law Enforcement and the Justice System
Several sessions discussed the role law enforcement plays in responding to behavioral health crises. For example, police officers and behavioral health professionals from New Jersey’s ARRIVE Together program participated in a panel discussion, describing how their co-responder approach helps support individuals experiencing behavioral health crises. Participants also learned about several justice system diversion programs that keep individuals with behavioral health needs out of jail and in the community, such as Recovery Court, Veterans Diversion, and the Juvenile Detention Alternatives Initiative. While these programs are led by the Prosecutors’ Office and/or law enforcement, behavioral health professionals, such as social workers and peer support professionals, play an integral role in supporting individuals in these programs.
5. Address Health-Related Social Needs
Identifying and addressing health-related social needs among individuals with behavioral health needs was a key topic of discussion. Participants were especially interested in discussing the need for stable housing among community members and available housing resources. During one session, attendees learned about housing programs for people with behavioral health needs from organizations and government officials providing these services. For example, Pathways to Housing PA spoke about the Housing First approach and Collaborative Support Programs of New Jersey spoke about their supportive housing options.
The Road Ahead
Middlesex County is continuing the Behavioral Health Partnership following a successful first year. Participants consistently provided positive feedback related to knowledge acquisition, networking opportunities, resource access, behavioral health insights, and community impact. While the first year focused on behavioral health services and supports in Middlesex County, the second year has expanded to explore national best practices and a deeper dive into topics introduced in the first year. This expanded focus allows stakeholders to explore innovative solutions from across the country to better support individuals with behavioral health needs. As the Behavioral Health Partnership continues, session topics will be tailored to stakeholders’ interests, such as culturally responsive care and navigating transitions from youth to adult systems of care for individuals with intellectual and developmental disabilities.
