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Linn's Mental Health Access Center sees needs growing

Gazette - 11/23/2022

Nov. 23—CEDAR RAPIDS — It's been a year and a half since Linn County opened its Mental Health Access Center, and the demand for mental health services in the county still is increasing.

The need is so great that the center may expand its hours to 24/7 and a Youth Assessment Center is being discussed.

The Access Center opened in March 2021. In its first full fiscal year — July 1, 2021 through June 30, 2022 — it saw 785 walk-in patients.

Currently, the center is open for walk-in hours seven days a week between the hours of 8 a.m. and 10 p.m. Access Center Director Erin Foster still is working on making the center available for walk-ins 24/7, but so far that has been a challenge.

"Working through opening the center was a feat and we have it up and running minus the workforce issues that affected us like everyone else," Foster said. "I wish we were open 24/7 but that's 100 percent connected to the workforce shortage. But we know based on what we've seen the last year and a half that these services are very needed."

Linn County supervisors provided $3.5 million in startup funding for the center, which is located in the building that formerly housed Linn County Public Health at 501 13th St. NW, Cedar Rapids.

Services include crisis triage and counseling, mental health evaluations and prescriber appointments, peer support, crisis stabilization and a sobering unit. Services are provided by AbbeHealth, Area Ambulance Service, Foundation 2, and St. Luke's Chemical Dependency.

Since the center receives funding from the East Central Mental Health Region, it is open to individuals from nine counties: Benton, Bremer, Buchanan, Delaware, Dubuque, Iowa, Johnson, Jones and Linn. The counties' property taxes help fund the access center.

Numbers on track to surpass first year

So far this year, the numbers are on track to surpass the first year. In the first three months of FY23, 310 walk-ins have come through the Access Center's doors.

Last year, law enforcement referrals were 124. In FY23 so far, that number is at 56. A key part of the center is that it provides law enforcement a place other than jail or a hospital emergency room to take people who are experiencing a crisis.

"I am really happy about our jail and hospital diversion rates," Foster said. "According to our surveys, 41 percent of our law enforcement referrals would've gone to jail if we didn't have the center, and 36 percent would've been taken to the hospital."

Foster added that outpatient surveys show that 35 percent of patients would have taken themselves to the ER or called 911 if there wasn't an access center.

"That is a huge success for us," she said.

Foster said she thinks the increase of patients is a combination of variables, from the center's community outreach, to its partnerships with nonprofits like Waypoint and simply more need in hard times.

"It's been a difficult three years," Foster said. "A lot of people have experienced loss and have now been looking at mental health from a personal standpoint. With COVID, the derecho and other world events, we know people's mental health has been affected and that's on the increase."

Another question the center's outpatient survey asks: If the Access Center didn't exist, what would you have done instead? Twenty-eight percent of respondents said they would have done nothing.

Around one in five adults in the U.S. experience mental illness, according to Mental Health America. In Iowa, that percentage is similar to the national trend, which is equal to 441,000 Iowans with a diagnosable mental, behavioral or emotional disorder.

Iowa ranks as the second highest in the nation for adults with mental illness going untreated at 44.2 percent or 181,000 people.

Linn County Supervisor Chair Ben Rogers said he thinks mental health has been more 'front of mind' for people because of the various factors that Foster listed as well, but also acknowledged that many people don't know where to go or what to do if they're experiencing mental illness.

"I genuinely feel like there has been a societal shift and we're talking about this and it's much more accepted," Rogers said. "You can bring mental health up to anybody and they relate because we've all had similar feelings and experiences. Talking about these things openly is the trend we want to be going in."

Moving forward for the Access Center, Foster said she would like to see the center offer its withdrawal management program in summer 2023. She also added that she is hopeful that the walk-in hours will be 24/7 in early 2023.

"We're close to making more hires," Foster said. "We have amazing staff here and we're not just looking for seat fillers. That can't happen here. The staff here truly have the core components of empathy and compassion, being able to think outside of the box and on their feet."

Rogers said the other challenge for the center is that in Iowa, funding for mental health services and substance use are separated.

"For an access center, providers are able to bill Medicaid for mental health services, but we have to use local property tax dollars to fund the substance use portion," Rogers said. "We're one of the few states that don't allow those fundings to be woven. It really handcuffs us."

"Something has to come along statewise with funding and reimbursement rates," Foster added. "To not view these services as specialty-type services is wrong and it's not doing anyone any justice."

Youth Assessment Center could be in future

Rogers and Foster are also both involved in the "very early" planning phases for a future Youth Assessment Center, which would provide mental health services to children and families. The Mental Health Access Center only provides services to adults.

"It would help youth and families in crisis access timely services," Rogers said. "It will help them to navigate the system. That's what we're working on now because children hopefully become adults someday and trying to address these issues early on in their life is statistically a lot better odds than helping them when they're older."

Foster said part of the planning process is making sure they aren't "reinventing the wheel" or causing more barriers indirectly for organizations and people seeking services.

"It would look different than the Access Center and have different providers and services," Foster said. "But when you look at crisis services and substance use, you have to cover the entire life span. Having only adult services doesn't cover everything that's happening here. There's absolutely a need for these services for children and families here."

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