TRAVERSE CITY — An assessment of behavioral health crisis services in northern Michigan points to what many already know: more services are needed.
The Grand Rapids-based TBD Solutions looked at 650 surveys completed by those who use behavioral services, families of those using services and those who work in the field to come up with recommendations for expanded options in the 12 counties served by Northern Lakes Community Mental Health Authority and North Country Community Mental Health Authority.
Mental health and substance abuse services fall under the behavioral health services umbrella.
Recommendations coming out of the study include developing and expanding crisis services with some new programs and by adding on to existing programs, said Travis Atkinson, director of clinical and crisis services for TBD Solutions. Atkinson presented the study’s findings Friday via Zoom.
That means more psychiatric hospital beds, crisis residential beds, a crisis stabilization unit for walk-in services that would also allow law enforcement personnel to drop people off instead of taking them to emergency rooms, and a psychiatric urgent care center that would operate for about 12 hours a day, Atkinson said.
Specifically, the study recommends a crisis stabilization unit in Traverse City; a six-bed crisis residential unit in Traverse City where people would stay for an average of seven days; a six-bed psychiatric urgent care in Petoskey; and 16 inpatient psychiatric beds in Cheboygan, six of which would be for children, though beds could flex between adults and children as needed.
Children in the Traverse City area who need mental health services are often sent to Grand Rapids, about 150 miles away. Cheboygan is closer at about 110 miles, but still more than two hours away.
Ginger Kadlec, executive director of the Traverse Bay Children’s Advocacy Center, said the CAC has three trauma therapists on staff and still has waiting lists for children and their families. There has also been an uptick over the last year or so in prior clients who are coming back for services, she said.
“It seems there is so much that we need to do on a regional basis,” Kadlec said. “While I appreciate that this is a good start, there are other things we can do to shore up the safety net for children who are experiencing mental health crises.”
Other recommendations are to minimize reliance on first responders, Atkinson said.
“For decades behavioral health emergencies have had to go through systems that were designed for medical emergencies,” Atkinson said. “What we’re trying to do is have the first service that people access be one that is focused on behavioral health emergencies and not one that is trying to do triage amidst medical emergencies.”
The study was done in six months in partnership with Munson Healthcare and McLaren Northern Michigan. It included focus groups with about 50 participants who talked about their own experiences with behavioral health services, as well as analysis of three years of data on things such as how many people presented to the emergency department with a behavioral health condition or how quickly people were served when they accessed crisis services.
“Northern Lakes will be assessing the reported recommendations and, through thoughtful planning with our community partners, will determine what can be accomplished,” Joanie Blamer, interim CEO for Northern Lakes said in an emailed statement. “We are committed to enhancing services to people who are experiencing a mental health crisis.”
Northern Lakes applied for about $5 million in grants in two years that, if received, will be used to open, staff and operate a 24-hour crisis stabilization unit with six residential beds in its downtown Traverse City administration building.
State Rep. John Roth recently told Grand Traverse County commissioners that funding for mental health centers in both Traverse City and Gaylord is coming to the region, though he did not have details on how much money will be available or how many beds the centers will have.
Atkinson said crisis services should also be available to all payer types, he said, though those who deliver services may have to prove that they can provide cost-effective services before commercial insurance companies will be on board.
“We want to make sure that your community has services which allow people to access them regardless of what insurance type that takes,” Atkinson said, calling it a no-wrong-door approach. “You’re not going to be shifted around or shuffled around based on what your insurance type is.”
Another recommendation would be to offer transportation for those who need to travel long distances to get to an available bed, an effort that would free up law enforcement personnel. Some other states have programs that rely on retired officers and military personnel and peer supports to provide transportation at a much lower cost, he said.
Atkinson said people who work in emergency departments should be trained to be empathetic towards those with mental illness and not use phrases such as “frequent flyer” to describe people who use services a lot.
“When you say frequent flyer you’re starting to place a set of judgements or beliefs on that person,” he said. “You have to keep that hope alive, that people can change and maybe this is the time that will be helpful.”
Kadlec is encouraged by the spotlight that is being shone on the mental health issue.
“Hopefully we’ll be able to come together as a community and figure out what works best for adults and youth,” she said. “I think this is a nut we can crack.”