Mental health crisis intervention update

By Jada Smook
The Montanian attended the mental health/ crisis intervention meeting held on Jan. 25, 2018 at Cabinet Peaks Medical Center. The meeting was one of many that are being held to ad-dress what measures will be taken to fill in gaps left be-hind from the closing of the Western Montana Mental Health Center (WMMHC) in Libby.
Since the sudden closure of Western Montana Mental Health, the company’s former clients and others in the community have been left wondering who will be avail-able to help when the need arises?

Even though we have other counselors here in town, there may be too many clients for the counselors to take care of in a timely manner. In addition relationship building with new clients can take a long time.
Most organizations rep-resented had previously re-ported their concerns includ-ing Lincoln County Public Health, Northwest Community Health Center (CHC), Youth Dynamics, Cabinet Peaks Medical Center (CPMC), County commissioners and others.

Libby Volunteer Ambulance (LVA) hadn’t previously attended meetings so Jeff Holder reported their concerns regarding the mental health crisis. He said that LVA is facing a shortage of volunteers and cannot regularly transport mental health patients because they would not be able to answer 911 calls.
The main topic of discussion was how to make mental health professionals avail-able for emergent patient needs.
One element of the re-sponse plan is to bring nu-merous mental health professionals onboard to be available for emergency consults one hour per week. If there were a schedule, then emergency mental health concerns could be handled more efficiently which might avoid the need to leave the community for help.
This idea is being further developed by Nancy Huus, emergency mental health services coordinator. She aims to improve the coordi-nation in local resources to meet the needs of our com-munities. One of her goals is to get mental health providers together face-to-face to build relationships and im-prove coordination of care. Nancy is also working to create an emergency plan in response to WMMHC’s clos-ing.

The CHC is and will re-main open to emergency consults six hours per week, but according to their Director Maria Clemmons, they don’t have the capacity to see everyone in Libby with only three counsellors.
Specifically, the people affected by this closure were wondering how emergency consults would now be handled.

There are many levels of mental health needs in the community. Most cases can be managed without inpatient mental health but some require commitments which can be either voluntary and involuntary. The idea is to provide mental health care more readily to avoid crisis and need for commitment which requires transport to receive treatment outside of the community.
Any licensed provider can do brief emergency con-sults, and a standardized checklist will be developed for the providers to use.

The Montanian talked with Jennifer McCully, Lincoln County Health Department’s Public Health Manager, about what other measures are be taken to help the clients from the mental health center.
“We are eventually plan-ning on finding people to train on how to care for the patients, so we have more people to help them,” McCully said.
Sunburst Mental Health Services will be offering out-patient mental health services, case management, private practitioners, and other services in the commu-nity to the former patients of the WMMHC, according to minutes from a community health meeting held in Eureka. Amy Fantozzi, Lincoln County Health Department’s Health Education Specialist provided the meeting minutes to The Montanian.
Patients can be referred to Sunburst Mental Health by a primary care provider or they can self-refer. Sun-burst can bill all insurances, but certain services are only covered by Medicaid.
Sunburst Mental Health Services in Libby was con-tacted for comment. “Sunburst continues to provide case management. There is also an HSS program at the school and a wraparound care for families,” said Elaine Maggi of Sunburst Mental Health Services.

More local services will help but the problem of transporting mental health patients to facilities located out of town remains.
Amy Fantozzi said, “The biggest challenge has been getting law enforcement involved.”
Roby Bowe of the Lincoln County Sheriff’s office spoke his feelings towards the situ-tion.
“Money can help, but it isn’t going to fix the community. I feel that it is important for people to step up and work together to meet the needs of the people. As a community, we need to be passionate about the positive things in our community and the great things that Lincoln County has to offer. It is important for organizations to be brought together and work together,” said Bowe.

Marcia Tharp of Senior Life Solutions, an intensive outpatient group counseling program specifically for seniors, also spoke about the problems. She said that the center will be providing long term services and also identifying other needs so they can connect their clients to other needed services.
According to minutes from a Mental Health Coalition Meeting held on Jan. 19, Carol Kelly stated that she felt somewhat isolated in private practice and that service coordination needs improvement.

Carol is from Circle Therapeutic Counselling Services which provides marriage and family therapy with a specialization in trauma.
Rita Billow, Clinical Phycologist at the CHC said she feels that the greatest success in service coordination has been identifying specific social determinates of health in our community. This has encouraged the clinic to start a food pantry and screen patients for food insecurity.
Other institutions such as CPMC’s Emergency Room, law enforcement, the jail, the CHC, and primary care pro-viders are being seriously impacted by a wave of clients in need of help that is no longer available from the WMMHC.

The number of organizations and facilities willing to help with former WMMHC patients has gone from six organizations to 17 organiza-tions.
The organizations working to address the problems include Lincoln County Public Health, the CHC, CPMC, the County Attorney’s office, County Commissioners, Youth Dynamics, Sunburst Mental Health Services, Libby Care Center, Unite for Youth, Children’s Advocacy Center, Libby Public Schools and others.
The Libby Public Schools and mental health care providers are working to improve communication to improve the overall care of kids in the school system
Jeanie Winstrom from Libby High School’s Alta Care said they have built relation-ships and put names and faces together so they can all work together to help with needs of the community.
Jennifer Fortner from Sunburst Mental Health Services is to thank for getting a case manager at the schools.

There is also a universal depression screening for primary care centers that is in the works at the moment. Tiffany Bradeen of Cabinet Peaks Family Medicine said, “My big success has been implementing the PHQ-2 (depression screening) consistently in the clinic. 95% of patients age ten and over have been screened. They will continue to screen new patients and strive for 100%.”
Concerns from the Libby meeting on Jan. 19 included the need for an emergency plan to cover adults in crisis at the ER, kids in crisis, dealing with the reduction of in-home services and case management, and an increase in substance abuse because of loss of services. The point of crisis management not working very well was also brought up.
Plans to get local therapists to do assessments when crises are underway, and plans to train ER staff in mental health first aid are in progress.
The next mental health crisis intervention meeting is scheduled for Thursday, Feb. 8, at 11:30 a.m. at the Libby Central School administration building.
Mental health crisis intervention update