Persons in Massachusetts who have a serious mental illness may not believe in guardian angels. But someone closely approximating such an entity has donated $12.5 million to McLean Hospital, Harvard University Medical School’s largest psychiatric teaching facility, to support services that directly benefit individuals with serious mental illness.

The donation was anonymous, and it is the largest single charitable gift that has ever been given to McLean or any of the other hospitals that are members of Partners HealthCare System.

Staff at McLean have decided to use the money to create a new model of community-based psychiatric care for seriously mentally ill individuals. Or as Bruce Cohen, M.D., Ph.D., president and psychiatrist in chief of McLean Hospital, explained, "We are creating a new model of psychiatric care delivery in which rehabilitation services are designed based on the specific wishes and needs of each individual. Most psychiatric rehabilitation programs are constrained to work on the opposite principle: They develop a program and must weave individuals into the framework of that program."

Each patient referred to the program will first meet with a treatment team to assess his or her current life circumstances, including housing, psychiatric services, medical care, education, employment, and social and spiritual needs. The team will then design a rehabilitation and living plan expressly for that person and develop specific services or tap existing services, such as those provided by the Massachusetts Department of Mental Health, in order to turn the plan into a reality.

"For example," said Paul Barreira, M.D., chief of community clinical services at McLean and the newly appointed program director, "while one individual may only need assistance in finding housing and accessing educational and employment opportunities, another person may request help in finding a supervised residence, acquiring prevocational skills, maintaining sobriety, or applying for Social Security benefits."

The length of time a patient participates in the program will also vary depending on need, Barreira noted. Some individuals may use the program to transition from an inpatient level of care to more independent living in the community. Others may need and want long-term, program-supported living.

The program will be based in Belmont, Mass. At a time of limited psychiatric services across Massachusetts, it is expected to reach hundreds of persons with chronic psychiatric illness, most of whom are living in, or wish to live in, the community.

"We need more models like this that provide the resources individuals need to function independently in their communities, rather than take up hospital or residential beds that are already in short supply," asserted Samuel Thier, chair and CEO of Partners HealthCare System.

Cohen and Barreira hope eventually to expand the program. "We already have had other private donors and pharmaceutical companies show interest in supporting this new model of psychiatric care delivery," Cohen said. ▪