Timpanogos Community Mental Health Center under-served patients last year, emphasizing one program - day treatment - to the detriment of others, according to a new clinical program review.

In his second report to the Timpanogos Mental Health Authority Board, Interim Director David Dangerfield said the review found that the center's patient load is well below the state average, but day treatment at the center is higher than any other mental health facility in the state."This is not good. It shows that they focused on one element on the continuum to the detriment of other programs," he said.

The program reviews - made by a quality assurance team that visited all programs, and through staff retreats with the staff of Adult and Children Services - found that the number of Timp patients is more than a third less than in other state mental health centers.

In a comparative analysis of the unduplicated number of patients treated at centers throughout the state, 1,300 patients per 100,000 population were treated at urban area centers. Timp Mental Health, however, treated only 651 patients per 100,000. This was the lowest patient load of any center in the state.

Patient load additions and discharges at Timp Mental Health were also below the urban average. There were 826 additions in urban centers compared to 358 additions at Timp Mental Health. Discharges at urban facilities were 757 patients compared to 367 discharges at Timp Mental Health.

"This is significantly below what we anticipated," Dangerfield said. "One of the major problem areas of the center is that it is underserving. We have to do something about that."

But in a comparison of mental health center day treatment programs, Timp Mental Health was way above the state average. The center treated 16,567 patients per 100,000. Urban centers treated 10,097 per 100,000.

"We need a stronger emphasis on care for the adult chronically mentally ill patient," Dangerfield said. "We are not providing enough."

Dangerfield cited several deficiencies in the present programs at Timp Mental Health, including the need for drop-in crisis treatment and psycho-social rehabilitation at the center, and a focus on work and transitional employment for the chronically mentally ill.

He said the center needs active treatment programming for clients in day treatment and self-support programs, and a short-term day treatment program. The present day treatment program primarily focuses on extremely chronic patients.

Development of day treatment activities through Wasatch and Summit counties accompanied by a plan of transportation is also a must, Dangerfield said. Timp Mental Health is located in Utah County, but is a tri-county facility serving Wasatch and Summit counties as well.

"If we are not utilizing the programs, then by and large we are not getting our money's worth," said Wasatch County Commissioner Larry Duke.

Dangerfield suggested a redistribution of Timp Mental Health funds could correct the problem areas to make the center more of a tri-county facility.

The clinical program reviews also pointed out that the center's emergency and crisis programs are weak because of poor public relations and communication between the crisis team and the treatment programs. Little available crisis outreach, lack of inpatient services, lack of medical staff coverage and a lack of outpatient staff for the size of the area being served were also noted as problems.

Dangerfield said Timp Mental Health is at approximately one-half strength in physician coverage. To correct this, the center is recruiting for a clinical director and staff psychiatrist. Two recruits from out of state already have applied and been interviewed.

Contracts for psychiatric services have also been made to help the center meet its need for medical services.

Davis County Mental Health Center is contracting with Timp Mental Health to provide eight hours of coverage a week $48 at $48 per hour. Timp Mental Health has also contracted with a psychiatrist to work for four hours a week at $50 an hour.

"This gives us 12 hours of coverage over and above what we had," Dangerfield said.