Substantial progress has been made in the five years since McLean County began an overhaul of community mental health, but some of the toughest work lies ahead, according to two McLean County Board members who served as architects for the ambitious Mental Health Action Plan.
A National Institute of Corrections study requested by former county sheriff Mike Emery of the mental health care at the jail proved a tipping point for more detailed scrutiny of not only the care inmates received but how mental health care was delivered outside the detention center.
Board chairman John McIntyre worked with member Susan Schafer to form two committees in 2014 comprised of stakeholders who spent months looking at mental health needs and best practices to deliver them.
The 92-page plan released in May 2015 laid out five priorities for improving mental health care: collaboration between providers, medication and medical management, juvenile services, housing and crisis services. As part of mental health reform, the county board moved forward with a $39 million jail expansion, which includes a mental health unit staffed with counselors.
But treatment within the justice system “goes for naught, as detainees return to unstructured and untreated environments,” the plan concluded. The board- sponsored report noted that without a better coordinated effort outside the jail to manage crisis calls and divert people from expensive emergency room visits and jail, no progress would be made.
The situation at the jail where inmates cycled in and out of the criminal justice system for lack of care in the community needed to be addressed on a larger scale, said Schafer. “The system wasn’t working. Something had to be done and no one was doing it. I thought, “let’s do it. Let’s get it done.”
The NIC report was an eyeopener for many people, said Schafer. “This was an outside group saying, ‘you’ve got a problem here.’”
Seventy-two people were invited to the first meeting to discuss the research needed for the mental health plan.
For McIntyre, his post-retirement work counseling and coaching high school students provided insight into the struggles families often face with confronted with mental illness.
“It’s a helpless feeling sometimes, if you can’t do much for people,” said McIntyre.
A chairman’s roundtable started by McIntyre brought stakeholders together to talk about gaps in services and solutions to fill them.
“When you get people to the same table, they learn more about each other and what they’re doing. We brought the social service agencies, first responders and hospitals together and others for those important discussions,” said McIntyre.
Crisis services were expanded as local providers improved their collaboration with each other and law enforcement. A new crisis stabilization center for short-term residential mental health needs opened at Chestnut Health Systems in Bloomington.
The McLean County Board of Health also made major changes to its funding process to better monitor how taxpayer money was spent for community mental health programs. New funding was allocated to boost counseling programs in schools and address youth suicides in the county.
In March, the county opened the McLean County Triage Center in downtown Bloomington for people experiencing a mental health crisis. Although only about 20 people have visited the center during the months of the pandemic, the county is confident those numbers will increase in the coming months.
Still to be tackled is the issue of mental health services for children, a challenge facing many communities.
“Services for kids is a high priority item,” said McIntyre.
The county recently had no applicants for funding for an intensive outpatient program for children. But Schafer and McIntyre said they intend to continue efforts to start a program designed to keep children out of the hospital and help transition them back into school after a hospitalization.
A shortage of psychiatrists for children and adults is also a challenge McLean County shares with many communities.
The mental health reforms in McLean County, like improvements to most community-based services, requires money. A sales tax increase approved by voters in 2016 provides about $4 million annually that is directed towards mental health programs, including the triage center. About $1.73 million has been budgeted this year for mental health work,
The tax funding has also helped provide housing for five people through the FUSE (Frequent User System Engagement) program. A stable residence is a key factor in helping people reduce hospital visits but convincing some homeless people to accept housing can be challenging.
The benefit of housing for mental ill people goes beyond their well-being, said McIntyre.
“For every person you help, you save $350,000 in services,” said the board chairman. Those savings, he said, can be channeled into community programs.
Hospitals remain a source of help for people facing mental health challenges.
“I think the coronavirus has presented a challenge for us as a society and has impacted mental health in a negative way,” said Chandler Brooks, nursing supervisor of OSF St. Joseph Medical Center’s emergency department.
The hospital has seen an uptick in behavioral and mental health visits during the pandemic. The increase includes adolescents who are coming to the emergency room, said Brooks.
Carle BroMenn Medical Center started the year with a seven percent increase in mental health-related visits to the emergency room, said hospital spokeswoman Lynn Hutley, then saw a significant decrease during April and May.
The numbers have gone up since June but remain below 2019, said Hutley.
The inpatient mental health unit at Carle BroMenn “has stayed at near capacity even when most all other hospital services experienced decreases,” said Hutley.
Carle BroMenn will boost its inpatient capacity in the coming weeks when the facility opens its renovated behavioral health services area. Inpatient capacity will move from 13 to 19.
Here’s a link to Short-changed: Unjailing the mentally ill, a documentary I helped produce in 2014 with Pantagraph photo editor David Proeber. We documented the crisis in McLean County’s mental health services and the work to make things better :