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Mental Health and Homeless - Forum #3 Monday, September 28, 2009 - 7 p.m. at Lawrence Public Library Next Forum - Monday, November 30, 2009 - 7 p.m. at Lawrence Public Library NOTE: If you already have background knowledge of this issue and already know the services provided for mental health and homelessness, you can skip directly to NEEDS, TRIGGERS and OPPORTUNITIES which only takes a few minutes to read. Also, Captain Ray Urbanek not yet viewed his comments for accuracy. PANEL: Kim Murphree - Moderator - KLWN Captain Ray Urbanek - Police Department Evening Shift Commander Dana Hale - Law. Memorial Hospital - V.P. of Nursing Eunice Ruttinger - Bert Nash Director of Adult Services Wes Dahlberg - Salvation Army Corps Administrator Lesa Weller - Recovery & Hope Network (RAHN) -Executive Director Loring Henderson - Lawrence Community Shelter - Director BACKGROUND According to the National Council for Community Behavioral Healthcare, mental health problems can be more disabling than many chronic physical illnesses. 'Disability' refers to the amount of disruption that a health problem causes to a person's ability to work, look after themself and carry on their relationship with family and friends. Most of us who have not experienced mental health issues can hardly imagine that severe persistent mental illness is as debilitating as a heart attack, that moderate depression is similar to the disability from relapsing multiple sclerosis, severe asthma, chronic hepatitis B or deafness. Only in recent years has it been recognized that mental health is a major issue in the United States. Although mental health problems alone are not the major killers, they are major causes of long-term disability. When mental illness is compounded with the crisis of homelessness, an individual without advocacy has little hope. The World Health Organization (WHO) Global Burden of Disease project further estimates that mental illness ranks second in the burden of disease in established market economies, such as the U.S. WHO stresses that approaches to mental illness should be fundamentally the same as approaches to physical illness. All too often, additional suffering is caused by attitudes of rejection and stigma towards people with a mental health problem. As Eunice Ruttinger, Director of Adult Services at Bert Nash Community Mental Health Center, stated at our September 28 meeting, when an individual has a mental illness it is like 'When our brain is not working, not telling us the truth, we can't make judgments about our daily life. These Forums on Mental Health and Homelessness are meant to inform and de-stigmatize this important issue in Lawrence. The minutes below reflect the needs, resources and gaps that exist in Douglas County. Your input to address these issues with solutions is greatly appreciated. The Minutes are divided below into two sections - DESCRIPTION OF SERVICES and NEEDS, TRIGGERS and OPPORTUNITIES. If you are already familiar with services in Lawrence, you may want to begin with the second section. DESCRIPTION OF SERVICES - The evening began with moderator Kim Murphree introducing each of the panelists and asking each of them for a description of their services, especially related to people who have mental health issues that are/or have experienced homelessness. Captain Ray Urbanek stated that the first role of the Lawrence Police Department is to protect - the people themselves or others. There are strict guidelines as to what the police force can/cannot do. In order for police to get involved, someone has to be of danger to themselves or others. Given those guidelines, usually law enforcement is in a situation of imminent danger and must act accordingly. Dana Hale said that she was called into represent the Lawrence Memorial Hospital at this meeting as Paula Dupigny-Leigh, RN, Clinical Coordinator for Mental Health was out of town. Dana reported that the Hospital has a Psychiatric Crisis Stabilization Service (CSS) available in the Emergency wing of the hospital and works in close partnership with Bert Nash Mental Health Services. This consists of three monitored safe rooms, plus a conference room where screenings are done by personnel from LMH/Bert Nash Social Worker. People can stay up to 24 hours or until the patient is stabilized or transferred to a psychiatric setting. If emergency care is needed services are available 24/7. The CSS offers low stimulation environment with a concentration on patient safety. It is staffed by a nurse who provides support, care, and one-on-one observation as needed. Mental health patients can be seen in the emergency department for medical care or for crisis stabilization. The CSS saw 689 people in 2008. The Emergency Department total (CSS and ED Main) for Mental Health in 2008 was 1,095. It is not exactly known what percentage are experiencing homeless as these records are not kept. Once someone becomes an inpatient, a social worker and/or the mental health coordinator are available to help with their care. Discharge planning and providing inpatient or outpatient resources are an integral focus of Crisis Stabilization. Eunice Ruttinger reported on Bert Nash, which is a comprehensive mental health center serving over 7,000 clients a year with services to adults, families and children in our community. Bert Nash provides outpatient therapy, Intensive Outpatient therapy, Community Support Services include case managers; medication services, 24 hours hospital screening services and comprehensive children’s services. Bert Nash also oversees four Outreach Workers who are primarily on the streets working with people experiencing homelessness. Carla Helm, who oversees the program, Jacob McKee and Brad Cook were in attendance. Jake reported that he has 20 cases right now and worked with 58 individual cases last quarter; Brad has 22 current cases and worked with 105 last quarter. This Bert Nash Center program is funded by the City of Lawrence, since 2007 and has been a very successful program by all accounts. Bert Nash provides service to people who are diagnosed with Severe Persistent Mental Illness (SPMI), as well as those who do not meet that diagnosis (less severe). That is important as most State and Federal funding streams require SPMI designation. Bert Nash screens an average of 120 people each month, with 10- to 20- of these individuals being homeless. Please see www.bertnash.org for more information. Loring Henderson said that the Lawrence Community Shelter is involved in the untidy end of things, working with an open population of people, many in desperate circumstances. And while there are a small percentage of people with repeated behaviors, the shelter is the last service available. There are quite a few success stories and thankfulness from people who are able to benefit from their time and the services at the shelter as they move into housing and employment (see www.lawrencecommunityshelter.org/success.html). Loring also reported that collaboration of service providers and volunteers has been positive and growing. The shelter has had strong success in its jobs program with the Good Dog! Biscuits and Treats, an entrepreneurial small business that employs and trains some shelter guests, with opportunities through the Change of Heart street newspaper, case management, and its Back-to-Work job counseling. The shelter provides dinner for up to 76 people each evening in the winter through a network of caring and generous volunteers and organizations who prepare and bring in the meals. The Lawrence Community Shelter has three to five families staying at the Shelter each night and has developed a strong family program for this population that is new to LCS. Loring reported that 35-40 percent of people who experience homelessness in Lawrence are dealing with some kind of mental illness. Many people don't have a diagnosis, but the longer someone remains in homelessness, the more that mental illness becomes a debilitating issue. The new stabilization unit at the Lawrence Memorial Hospital Emergency Room in conjunction with Bert Nash Community Mental Health Center has been a big help since it opened over a year ago in assessing people with mental health issues. Lesa Weller reported that The Recovery and Hope Network (RAHN) is a consumer run organization operated by and for adults with a mental illness who live in Douglas County. RAHN is a safe place that provides activities and group meetings (please see This e-mail address is being protected from spambots. You need JavaScript enabled to view it ). Wes Dahlberg reported that the Salvation Army has refocused their programs in the last year to work with families and individuals who are currently homeless to get them directly into housing and employment. Salvation Army provides case management, community lunches every Monday, Wednesday and Friday, plus a warming and cooling center from 5 p.m. - 8 p.m. daily. The Salvation Army has applied for a HUD Housing program, but it is difficult without already having an existing program. Please see www.salvationarmy.org for more details. NEEDS, TRIGGERS AND OPPORTUNITIES - Lesa Weller suggested that we need Crisis Intervention Training for greater coordination between service providers. She said that a training provided by service providers to the Police would be a great asset. Ray brought up that their role is not really service provision, but safety - plus the amount of trainings that the police must deal with along with their duties makes this a challenge. Lesa also stated that we need free services to people with mental health issues funded by SRS and fundraising. Wes Dahlberg stated and others agreed that Housing is the #1 need in our community - permanent, permanent supportive, transitional and emergency housing. Without a stable environment, especially living in homelessness, services can be largely ineffective. Eunice reported that Bert Nash has about 100 clients in housing, plus Hope House, which provides 6 units of housing for dually diagnosed individuals (mental illness plus alcohol/drug addiction). The Lawrence Housing Authority recently received a $648,000 grant for housing through a homelessness prevention grant www2.ljworld.com/news/2009/oct/01/lawrence-awarded-648000-homelessness-prevention-gr/. Kim questioned how we can do a better job of providing/developing funding for housing. Wes said that supportive housing is expensive and time consuming. Steve Ozark brought a flyer for a successful housing program begun through our community InterFaith Initiative called Home-Makers 5 Loaves at 500 Missouri which offers permanent, supportive housing to two women with mental illness who were formerly homeless. Home-Makers/5 Loaves OFFERS THEIR EXPERIENCE AND MATERIALS FOR OTHER GROUPS TO OPEN MORE SITES WITH SUPPORT FROM THIS SUCCESSFUL PROGRAM. Contact Katherine Dinsdale at This e-mail address is being protected from spambots. You need JavaScript enabled to view it Loring said that building trust with people, listening but also setting boundaries is the key human element. Loring said that we wouldn't know homelessness the way we do if it weren't for the mental health issue, where shelters and jails have become the housing programs when mental health hospitals were closed or under-funded for long term care (see www.en.wikipedia.org/wiki/homelessness_in_the_United_States). Lesa also said that getting information/education out the community is needed. Mental illness has numerous stigmas and prejudices that can only be changed in people's mind through first-hand experience and education. Eunice said that education is critical to break through stigmas. Bert Nash's Mental Health First Aid program is offered on a monthly basis and is an excellent overview and will give you the tools of how to respond in a situation or crisis - www.bertnash.org/services/mentalhealthfirstaid.org. Loring said it is an issue for people without support systems to get basic things like having identification, a driver's license or a birth certificate. This could be solved by an organized volunteer effort. Disability, Medicaid or Medicare and Tax Refunds are available to some people who just don't have the advocate to help them apply. Ray said that they see some of the same people numerous times a week - how can we help people in a meaningful way? If we could get beyond the restriction of being of immediate danger to themselves - can we change that in the State of Kansas? Kim asked about people resources. What gaps can be addressed, or existing programs aided - through volunteerism? When and where are volunteers appropriate for people with mental health issues? Loring said that The Shelter wouldn't exist without volunteers, but volunteers are not used for mental health issues, due to safety concerns and training courses. With very limited long term housing and no long term in patient services in Lawrence, Lawrence residents are often limited to 3 days or less when sent to facilities in Kansas City, Topeka or Osawatomie. Lesa reported that RAHN offers a Wellness Recovery Action Plan which people put together for themselves. This is a course written by Mary Ellen Copeland in an attempt to keep individuals out of the hospital and coping at home with resources available in the community. The class is offered every Wednesday at 3:00 p.m. at RAHN. Headquarters offer invaluable mental health crisis services, but it is understood that few people experiencing homelessness use this service. www.hqcc.lawerence,ks.us The National Alliance on Mental Illness is restarting in Lawrence. www.nami.org Loring that there is national Health Reform Legislation - more people will get more services, so there will probably more limits on what can be offered to each individual. Loring reported that the proposed national health plan probably will put insurance levels for the plan to make mental health care on par with physical health care. Dana reported that it is hard to find trained professionals from when the mental health units closed up. Wes reported on the Second Chance Act with the Department of Justice, where volunteers go into the jails 6- to 8- weeks before release. The Douglas County Corrections Facility has successful programs for re-entry going; volunteers are needed www.dgso.org or www.jailtransition.com Respectfully submitted, Steve Ozark This e-mail address is being protected from spambots. You need JavaScript enabled to view it 760-3143 |