(Editor’s note: Catholics looking for ways to put faith into practice during Lent and beyond can get inspiration from others around the diocese working to make the world a better place in which to live. Each week during Lent we’ll profile projects, people and activities striving to make a difference.)
By Lindsay Steele
The Catholic Messenger
CENTERVILLE — As a physician assistant, Dewey McConville saw people with immediate mental health needs pushed aside again and again in their small community, treated without the urgency of someone having a heart attack, for example.
“I saw how very hard it was to get any sort of mental health evaluation or treatment plan for people with mental illness,” she said. “The emergency room was packed with people with mental illness who weren’t being properly evaluated (due to availability of trained staff) … A small, rural emergency room doesn’t have the capacity.”
Stories like these inspired McConville and other members of St. Mary Parish in Centerville to make mental health care more accessible in their small community.
“I think people have been stereotyped and discriminated against for so long,” said parishioner Jackie Sharp, a licensed therapist. “When they do try to seek help there are so many barriers to getting appropriate help. It is really important for us to step up and make services available.”
About two years ago, Sharp, McConville and other parishioners formed a coalition to identify problems and solutions regarding mental health care in Centerville. The other parishioners are Diane Buss, Appanoose County Mental Health coordinator and Ann Young, vice president of Mercy Medical Center – Centerville. They were joined by representatives from the Appanoose County Sheriff’s Department.
McConville said: “(As Catholics) we are supposed to be reaching out to the marginalized and I can’t think of anyone in our community that is marginalized more than those with mental illness. We think of mental illness as a weakness or a failure instead of what it really is: a brain disorder.”
Together, group members discussed the strengths and weaknesses of local mental health care. They discussed the lack of timely evaluation and treatment. “Some persons with suicidal ideation were waiting up to one month for outpatient psychiatric services,” said McConville. Those with less severe mental illness needs might wait two to three months.
The coalition also examined emergency room challenges. Without a regular mental health professional on staff in the emergency room, patients needing immediate inpatient care often waited 8 to 12 hours for referral and placement. They had to be transferred elsewhere, sometimes to Des Moines if beds were available, other times farther away to Sioux City, Iowa, or Omaha, Neb. McConville said this transfer was costly to the county because it required police escort.
Most of the people transferred to inpatient care would have been better suited to a more intermediate crisis stabilization home where they could be supervised in a safe place within the community, Sharp said. At the time, this type of service did not exist locally.
After identifying the issues, the coalition brainstormed solutions that included implementing a new plan to help handle mental health cases in the emergency room at Mercy Medical Center-Centerville. The emergency room now has a call rotation of mental health professionals for emergency mental health crises. This helped reduce the wait list for outpatient psychiatric services to 24-48 hours, Sharp said.
The coalition also worked to set up Oak Place, a crisis stabilization center. It is intended for people who are sick enough to be in crisis and need services, but not sick enough to require inpatient commitment at a psychiatric hospital. Sharp and McConville said this type of environment is more appropriate than inpatient care for about 80 percent of mental health patients.
Oak Place is a three- bedroom, ranch-style house with room for up to five residents – free of charge. The average stay is five to seven days. “They will get an evaluation and one-on-one support and medication, but they can walk away at any point. It is not a lock down,” McConville said. Immediate needs are met by on-site staff and residents have access to area mental health professionals. McConville said the local aspect of Oak Place is vital for those needing services. “You know what services are available in your own community and it is easier to link someone up with service locally.”
Oak Place, which recently celebrated its one-year anniversary, received an initial grant of $50,000 from the county, with a monthly stipend for staff, food and expenses. Catholic Health Initiatives, a national health care system that includes Mercy-Centerville, offered a $210,000 grant through its Mission and Ministry Fund.
Sharp, who has provided services to residents at Oak Place, said they have responded well to the crisis stabilization center. “Statistics show that people appreciate treatment, are in the process of receiving what they need and have connections with outpatient services (upon their departure from Oak Place) and trust us to come back for support.”
Lisa, a woman from Ottumwa, entered Oak Place after a depression-related suicide attempt. Having previously spent time in hospital psychiatric wings, she said Oak Place was a better fit for her. “At a hospital… they just try to make sure you’re not trying to hurt yourself. You don’t have that person to go and talk to. They just want to get you in and out,” she said.
Calling Oak Place “probably one of the best programs out there,” she said the staff and residents feel like family and there is always someone to talk to, even if it is in the middle of the night and she’s frightened by a bad dream. “Your problem is pretty much handled by the time you leave but if you need anyone afterward, you can call or go back to see them. They talk with me once a week to make sure I stay on track.”
The women from St. Mary’s say they are pleased with the progress the initiatives have made in a relatively short period of time. They hope to continue efforts to increase access to mental health care and reduce the stigmas associated with mental illness. The community coalition meets monthly and has expanded to include an increasing number of mental health professionals in the community.
Sharp said the community has begun to look at mental health in a different way by embracing the challenges of mental illness as opposed to misunderstanding them. “At least 90 percent of people with mental illness can be very productive members of communities like ours.”
“There is so very much to do,” McConville said. “But for each person we help in any way, we are giving that person hope and telling him or her, ‘You are not alone.’”
Parish members start NAMI chapter
Dewey McConville and school nurse Patty Tresemer, both members of St. Mary Parish–Centerville, started a local National Alliance on Mental Illness (NAMI) chapter. Since it originated a little over a year ago, NAMI of South Central Iowa has established support groups and classes for persons and family members living with mental illness. They have also sponsored community awareness lectures “so there is more discussion and community understanding of mental illness,” McConville said.