A community response to a mental health nightmare is slowly turning on the light for McLean County residents with chronic mental illness but few financial resources.
A creative solution among human services organizations has meant that 108 people with mental illness but without health insurance (including Medicaid) are getting the prescription medicine and counseling that they need. These are residents who — until recent months — had not been served since 2009 after the Center for Human Services, McLean County’s mental health agency, had to cut services to uninsured individuals who didn’t qualify for Medicaid because of a state budget reduction.
“These are 108 people who we would not have been able to serve before March because they wouldn’t have been eligible for our services after the state cuts,” said CHS Executive Director Tom Barr.
But United Way’s Health Vision Council — including representatives of health and human services organizations — worked with CHS to develop an advance practice nurse program. Advance practice nurses have authority — with psychiatrist oversight — to prescribe and manage psychotropic medications for people with a diagnosed mental illness.
Hiring an APN would be more cost-effective and timely than using the services of existing but overbooked psychiatrists. Seeing an APN would allow clients access to counseling and prescription medication programs.
United Way, McLean County Health Department and John M. Scott Health Resources each provided $25,000 to CHS for the next year to cover APN services. Wenjing Cao, who worked as an advance practice nurse in Kentucky, was hired and began treating CHS patients in March.
Eight months later, people involved with the program agree that it is building steam but more work needs to be done.
“We were slow in starting to get the word out” about services resuming, Barr admitted. “But we should be on target to hit our goals to serve 1,000 unduplicated clients — including 150 non-Medicaid clients — by June 30, 2013.”
“They’re on track to hit their projected outcomes,” said Greg Cott, president of United Way of McLean County.
“I think we all are surprised that the (150) slots didn’t fill up immediately,” said Karen Zangerle, executive director of PATH (Providing Access To Help), the 24-hour crisis information and referral agency. “But when you say ‘no, that’s no longer available’ for a long time, people stop asking.”
When CHS made the cut in 2009, 150 clients were impacted. These are people with chronic mental illness — such as bipolar disorder, schizophrenia and depression — who frequently have another illness and are poor, said Cao.
“These are people with the greatest needs and the fewest resources,” Barr said.
In addition to trying to manage their mental illness, they are struggling to pay bills, buy food and maintain shelter, Cao said. Some are homeless.
Without regular access to psychotropic, prescription medication, some people began “acting out” in public. More people with mental illness were arrested, more were being treated in area hospitals’ emergency departments and admissions to Advocate BroMenn Medical Center’s inpatient psychiatric unit increased by 16 percent.
Since March, CHS has served 834 low-income clients in its medical program, Barr said. About half are on Medicaid and can access medicine through state programs. The other half are non-Medicaid and CHS gets them medicine through indigent drug programs sponsored by pharmaceutical companies.
Of the 834 clients, 204 have been added since mid-March, Barr said. Ninety-six were on Medicaid and 108 were non-Medicaid.
“The work of Wenjing is critical for them to remain independent, which helps them and the community as a whole,” Barr said.
“I think the program is going well,” Cao said. “The caseload is increasing, I have a good relationship with my clients and they have given me good feedback.”
Some clients would have been hospitalized, some are able to keep their jobs, continue to go to school and maintain relationships with their family, said Sue Pirtle, CHS program manager for medical and counseling services.
“We’ve seen peoples’ lives impacted,” Pirtle said.
Whether the program is impacting activity in hospitals’ emergency departments and in Advocate BroMenn’s psychiatric unit is unclear. There have been no changes in Advocate BroMenn’s numbers, said Renee Donaldson, director of behavioral health.
But Donaldson added that, as state mental health institutions close, more hospital emergency departments from out of the area are transferring patients to BroMenn’s psychiatric unit. Many hospitals do not have a psychiatric unit.
“Will our numbers go down?” Donaldson asked. “That is definitely our hope. Do I believe that the (APN) program is essential to the community? Absolutely. I think it’s incredible the way the community has come together to meet the need.”
Meanwhile, Advocate BroMenn several months ago hired a crisis admissions counselor who screens emergency department patients with behavioral health issues, provides an assessment and assists in determining the needs of the patient.
Mental health calls to PATH’s 24/7 crisis hotline have gone from 2,057 calls during the first quarter of 2012, to 2,385 calls during the second quarter, down to 1,929 during the third quarter, Zangerle said.
“I don’t know that you can draw a straight line to the new services at Center for Human Services. But they can only help,” she said.
“We want people to know ‘You are not alone. There is help. There is hope. There is a next step you can take,’” Pirtle said.
Cott said the funding agencies have committed to funding the program through June 30, 2014.
“I don’t see the need for this going away,” Cott said.
For people whose level of anxiety or mental illness is affecting their work, school work, sleep, eating habits or relationships, or for people who have become withdrawn, hostile, threatening or delusional, there is help:
- Call a doctor, counselor, pastor or your Employee Assistance Program
- Contact the Center for Human Services at 309-827-5351 or PATH, the 24-hour crisis hotline, at 309-827-4005 or 211.