Ill. Pilot Program May Improve Mental Health Patient Outcomes

Rockford Register Star, Ill.

Apr. 12—The often frenetic pace of a hospital emergency room can be the opposite of the calm environment needed by people experiencing a mental health crisis.

Yet when families in Rockford and across Illinois call 911 for help with a loved one suffering from a psychotic, schizophrenic or depressive episode, there is only one place ambulances are allowed to transport the patient: the emergency room.

That would change under a proposed Rockford Fire Department pilot program that would allow Rockford paramedics to transport patients, when it's appropriate, to the Rosecrance Mulberry Center, Fire Chief Derek Bergsten said.

"All of the local hospitals have staff that can treat mental health patients if they're in crisis, but if you look at the research, the emergency room is not the best place for many of them," Bergsten said. "It's loud and it's bright. This is about getting them to a safe place where they are comfortable and that is suited for the type of issue they are experiencing."

The Rockford City Council is expected to vote on the proposal next week. The program is expected to be cost-neutral to the city, but could reduce repeat ambulance rides if it improves patient outcomes. If the proposal is approved, Rockford fire would become the second department in Illinois to pilot the option to transport to an alternative facility.

Rosecrance treats individuals suffering from mental illness and drug addictions. The Mulberry Center combines two mental health programs—triage and residential—said the facility's manager, Nathan Whinnery.

Triage includes crisis intervention, screening, evaluation and referrals to service providers including, if needed, the short-term crisis residential program also housed at the Mulberry Center. Most patients are insured by Medicaid, but the Mulberry Center also accepts private insurance and can sometimes find grants to pay for the care of people without coverage, Whinnery said.

Using a "living room" concept, the triage center offers roomy reclining chairs in which those in crisis can decompress and nap. There is a kitchen where visitors can grab something to eat or make a cup of coffee. And there are offices where mental health providers can speak privately with patients.

"It's designed to be comfortable," Whinnery said.

Triage services were used about 90 times a month, or nearly 1,100 times, last year.

Patients leave triage in less than 23 hours. The goal of the Mulberry Center is to avoid unnecessary hospitalization or incarceration of people in crisis by getting them quickly assessed, stabilized and referred for further treatment.

Most of the 950 patients transported to emergency rooms last year for mental health crises by the Rockford Fire Department still would go to the hospital under the pilot program because of urgent problems, such as physical wounds, a suicide attempt or an imminent suicide attempt, said David Gomel, president of Rosecrance Inc.
Rockford is working with Rosecrance and with the Illinois Department of Public Health to secure a waiver from state requirements that will allow Rockford fire ambulances, following assessment by a paramedic, to transport patients to the Mulberry Center, Gomel said.

Last year, 350 such patients would have met the criteria for transport to the triage center. The center is staffed by specially trained mental health professionals "around the clock" and will have the capacity to meet the demand, Gomel said.

Gomel said the triage center is designed to calm and soothe. Sometimes the best first step in the treatment process there is a cup of coffee, a shower or a change of clothes.

"It's dimmed or muted lights. Dimmed and muted colors. Low volume," Gomel said. "We are trying to create an atmosphere to help someone de-escalate from crisis."