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Fragmented mental health services seen needing hub

STORY BY MEG LAUGHLIN (Week of May 1, 2014)

In February, Lisa Kahle, director of the Mental Health Collaborative, took on a daunting task: Trying to figure out how to improve mental health care in a county where 8,200 people have serious mental health issues. Last week, she reported that much progress has been made.

With the help of seasoned Pennsylvania mental health consultant Michael Felix, Kahle spent untold hours over the past three months taking small, detailed steps to break the challenge down and see how best to deliver the services the county needs.

What’s needed, they found, is a hub – a mental health care tracking station or control tower, of sorts – to connect people who have mental health issues and the staffs of 21 nonprofits, private psychologists, psychiatrists and therapists, as well as school leaders, the judiciary and law enforcement.

Such a central facility would go a long way toward helping those with mental health issues receive the comprehensive and continued treatment they need.

To reach that conclusion, Kahle and Felix held about 30 meetings with just about everyone involved in mental health treatment, ranging from nonprofit teams that serve the mentally ill to those dealing with substance abuse, to funders like the Hospital District, the United Way, the McCabe Foundation, the sheriff’s office and Indian River Medical Center.

They also met with physicians and therapists, as well as school leaders and sheriff’s office administrators and judges. And they met with people with mental health issues and their families.

The questions: What are the problems? What do you suggest we do about them?

The problems: Services can be fragmented, isolated and not readily available. One hand doesn’t know what the other is doing. People fall through the cracks. Often when there is a dual diagnosis – like addiction and mental illness – only one thing is treated. Finances are limited. Mental illness is still fraught with shame.

The suggested solutions: Publishing a detailed guide to services; creating a central place to oversee referrals, coordinate care and follow-ups; involving those in private practice and community leaders from law enforcement to the courts to the schools; and educating people.

“A Community Access Center is the natural next step,” Hospital District Trustee Alma Lee Loy said after listening to the presentation last week.

To better define what “the tracking station” will do, Kahle and Felix are setting up four volunteer task forces to look at how to connect people to treatment, how to divert them from jail, how to help school personnel and private physicians and therapists become more involved and how to lessen the stigma of mental illness.

The four volunteer groups will research, meet regularly between May and October, and then present their recommendations in the form of business plans with listed resources and associated costs in November. 

“This is exciting,” Trustee Gene Feinour said.

Felix, who has traveled around the country for 40 years helping communities improve mental health services, said what amazed” him most about Indian River County was “the quality of the leadership. From Lisa (Kahle) with the Mental Health Collaborative to Ann Marie (Suriano, executive director of  the Hospital District) to Leonora (Richie of the McCabe Foundation) to the Hospital District, United Way  and the sheriff’s office, you have, all across the board, great leadership here – people who really want to work together to make this a better place for everyone.”

Feinour agreed: “This is an unusual county. We have a huge number of people at or below poverty line, and we also have a four- to eight-month transient population that is hugely generous – whether it’s for the hospital, the theater or the museum – who take care of costs so that good people can be brought to the effort.”

Suriano credited community leaders and philanthropists in Vero Beach with continually creating “private and public partnerships. Perhaps philanthropists will also see this worthwhile project as an opportunit.”

Statistics from the National Institute of Mental Health are encouraging: They show that 80 percent of people with clinical depression are successfully treated, as well as 60 percent of people with schizophrenia and 60 percent of people with substance abuse disorders.

Locally, the Mental Health Association treated 1,582 patients over the past year, and the Behavioral Health Center, which is part of Indian River Medical Center, admitted 744 people last year who were deemed a danger to themselves or others under the Baker Act.

Sheriff Deryl Loar said over 55 percent of inmates in the county jail last year had documented mental health issues.

“We see a high profile of mental illness among people who have guns and this is very disturbing,” said Loar, who said his goal, along with Judge Cynthia Cox, is to help establish a mental health court, as part of the community access center.

“When people come to court with mental health problems, we need to get them support. We need to do everything we can to get them mentally stable and into a healthy mindset,” said the sheriff.

Kahle often refers to a successful mental health community access program, which was developed with Felix’s help in Larimer County, Colorado, between 2002 and 2007.

The program, described in the Robert Wood Johnson anthology, is a model for mental health care across the country and similar to what Felix envisions here.

The anthology description of it concludes: “It succeeded because of the remarkable goodwill and camaraderie of the providers, consumers, advocates and others.”