A number of factors have been cited in the growing mental health services crisis in McLean County. They include an increase in the number of adults needing services, a shortage of psychiatrists to provide medication and treatment, and declining financial support.
For 45 years, Chestnut Health Systems has provided behavioral health services in McLean County. In our view, fragmentation of services is perhaps the biggest obstacle to providing a system of care that is best for the patient and offers the greatest hope for sustainable recovery.
A person in this community facing a mental health crisis might interact with a half-dozen separate service providers — an ambulance, a hospital emergency room, a mobile crisis team, a hospital in-patient mental health unit, a non-hospital crisis residential unit, and soon, a crisis triage center.
Consider that 50 percent of people with mental health conditions also struggle with a substance use disorder and the number of providers grows even bigger. Coordinating a patient’s care becomes challenging, if not impossible. The process of accessing care can be confusing for patients. Following a mental health crisis, follow-up services are critically important. Given the dynamics described here, those services are not routinely accessible or delivered, increasing chances the cycle repeats itself.
This fragmentation is not intentional. Service delivery silos have become entrenched over time. Our community is not unique in this regard, although this approach is becoming increasingly rare and is not considered a best practice. Typically, a single community-based organization provides the majority of mental health and substance use services. Chestnut fulfills this role in Madison and St. Clair counties. The Human Service Center does so in Peoria County, as does Heritage Behavioral Health Center in Macon County.
We see several solutions. The first is appropriate diversion away from jails and emergency departments that are frequently the wrong setting for someone facing a mental health crisis. Across the country, such patients are held in hospital emergency rooms for hours or days where their condition worsens because no other option is available. Or they are discharged with a safety plan, but without easy access to follow-up treatment or supported housing. Police and fire rescue squads should have the option of transporting psychiatric patients instead to a crisis triage or crisis residential program.
Second, comprehensive crisis services would ideally share a campus and a team of providers, enabling better care coordination and easier transitions for patients between levels of care and preventing the patient from “falling through the cracks.”
Third, those who care for patients with mental health issues should have the expertise to also assess and intervene with substance use disorders, given the high incidence of patients who suffer from both.
Many people in our community care deeply about making sure treatment is available. The Behavioral Health Coordinating Council, established by McLean County government, has made significant progress in bringing together entities to address challenges and coordinate care. More recently, the county has funded three new services to address this crisis. Its leadership is appreciated.
The community has the individual components for an effective mental health care system. However, services lack integration, coordination, and efficiency at a level to effectively confront the problem. There is an opportunity to do much more. In the interests of those who suffer mental health crises, it is imperative that separate service providers work in a unified direction and function as one provider team to solve a community problem.