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Silver Hill's urgent assessment program in New Canaan aims to connect young people quickly with follow-up care
Summary
Silver Hill Hospital told the New Canaan Health & Human Services Commission that its urgent assessment program, which surged after a local suicide cluster, serves mainly younger residents, has reduced per-town costs through shared funding, but faces challenges finding insurance-accepting follow-up clinicians and low insurer reimbursements.
Silver Hill Hospital representatives told the New Canaan Health & Human Services Commission on Feb. 5 that the hospital's urgent assessment program provides rapid, same-day clinical assessment and referral for residents in crisis, is heavily used by younger people, and has stabilized in cost and demand since its 2022 start.
Jason Perillo, director of strategic partnerships at Silver Hill, said participating towns hold weekly "slots" of capacity and that the program has seen "peaks and valleys" in demand. He said the program ran higher volumes in the months after a local suicide cluster and that, "when people needed the program, it was there for them." Perillo added that the program's per-town cost has fallen as other towns and funding partners joined since the initial ARPA-supported launch.
Perillo told commissioners roughly 47% of patients historically are referred to in-network clinicians and about 30% to out-of-network providers; nonetheless, he said insurer reimbursement for the assessment visits is "very low, bordering on nonexistent." He described that locating clinicians who will accept a patient's insurance and who can offer timely follow-up appointments remains one of the biggest operational challenges.
Liz Moore, Silver Hill's director of community relations, described survey results showing high patient satisfaction with clinicians and appointment timeliness, but weaker outcomes where referrals did not meet patient needs. Moore said the assessments are brief and not full diagnoses, and that many patients present with depression or anxiety; substance use sometimes emerges later in the conversation.
Commissioners pressed Silver Hill about program impact measures. Perillo and Moore said comparative pre/post analyses of hospitalizations or EMS calls for suicidal ideation are difficult with small sample sizes and reporting limitations, but they cited anecdotal cases in which families avoided emergency-room visits after using the program. They said Silver Hill is analyzing survey data and is open to working with local hospitals and EMS to build better outcome metrics.
Silver Hill outlined steps to increase early use and reduce stigma, including renewed marketing, clergy outreach, school events, anonymous testimonials and engaging interns for social-media outreach. Perillo and Moore said they have discussed adding neighboring towns (they welcomed Westport's recent participation) but want to preserve the program's tailored service to New Canaan.
The commission thanked Silver Hill for the presentation and suggested follow-up on measurement and coordination with local hospitals. The hospital indicated it would continue data analysis and community outreach and return with updates as requested.
