March report, part 1 (long form) Behavioral Health Services in Hennepin County

MPD Second Precinct Advisory Council (2-PAC), March 14 meeting report.  10 attenders. 

Our speaker is Kate Erickson, a manager at Hennepin County in Behavioral Health.   Erickson has 20 years’ experience implementing services for those with needs related to mental health and substance use.   We asked her to introduce us to many of the vital services offered at the Behavioral Health Center located at 1800 Chicago Avenue in Minneapolis.  The Behavioral Health Center at 1800 Chicago is an important place where first responders (including MPD officers), crisis counselors, family and friends can transport people who need immediate help from experienced providers of mental health and substance use services.  Hennepin County residents 18+ can walk-in to request advice or help for themselves.

While the City of Minneapolis has been engaged in many discussions about city services, new funding and defunding, restructuring, out-sourcing, and related topics, some residents began wondering what we really do have left out there.  

The Behavioral Health Center at 1800 Chicago is a substantial building, comprising 3 floors over 102,000 square feet.  The first floor has walk-in and recovery-based services.  The second floor is a crisis residence.  The third floor focuses on withdrawal management. 

What the Behavioral Health Center is:

  • It is a Specialty Center for Hennepin County residents (18 years and over) who are living with a mental health or substance abuse disorder.
  • It is a “blended environment” with services offered by Hennepin County and contracted agencies. The contracted agencies providing services at this time within 1800 Chicago include American Indian Community Development Corporation (AICDC), ReEntry House Crisis Stabilization Services (REH), Rainbow Health, Hennepin Health Care Services (HHS), Mental Health Resource (MHR), and Change Healthcare. 
  • It is focused on improving a client’s quality of life by
  • Reducing unnecessary emergency room use,
  • Reducing unnecessary inpatient hospitalization,
  • Reducing unnecessary criminal justice involvement, and
  • Increasing access to community health supports

Taking it floor by floor:

The Third floor is for people going through withdrawal; it is operated by the American Indian Community Development Corporation (AICDC).   It is a 60-bed facility which provides detoxification and withdrawal management from alcohol and/or drugs.    It assists clients who want to connect with services  and support.   This floor is open 24/7.  As people arrive on their own, with family members or friends, or transported by EMS or Police, they are admitted at the Walk-In door on Columbus Avenue.  Within 72 hours of intake, a client will receive a comprehensive assessment to determine what treatment is needed for recovery support.  If an individual is ready to go to a substance use treatment provider, they can be transported, door-to-door.  An individual does not have to be ready to go to a different treatment center, “We meet people where they’re at.”

The Second floor is a Crisis Residence, operated by ReEntry House Crisis Stabilization Services (REH).   It is a 16-bed facility, which provides crisis stabilization for 3-10 days.  It assists clients in connecting to mental health services and supports.   It is always open, but requires pre-registration and screening to make sure this service can meet the person’s needs.    If it’s not a good fit, the Walk-In services on 1st floor can assist residents in finding other services and supports.

The First floor is the Walk-In Center operated by Hennepin County Behavioral Health.  It has 12 assessment rooms and two treatment rooms.  The Walk-In Center is for Hennepin County residents, 18 years and older, who have needs related to mental and chemical health.  Services provided include triage & assessment, meeting a client’s  immediate needs and then helping them connect with services that can provide on-going, meaningful support.   The Walk-In Center is open M-F, 9am to 5pm.    The teams working at this center include office support, case management assistants, social workers and care coordinators, peer recovery support specialists, a medical provider, a medical assistant, and supervisors.

Scope of Service:  The Walk-In Center provides triage, assessment, intervention, resources and referrals for

  • Mental health/behavioral health,
  • Chemical health or substance abuse disorder,
  • Medical health,
  • Health and wellness,
  • Basic needs, social services and community resources.

Outlining the scope of service for persons with Mental Health/Behavioral Health issues, the center provides triage, assessment, intervention, resources and referrals, including but not limited to: coping strategies and resources for symptom management; scheduling a diagnostic assessment (DA); connecting to therapy, psychiatry or medication management; connecting to community-based mental health services; or coordinating case management referrals for long-term management and supports.

Services provided for persons living with Chemical Health or Substance Use Disorders follow the same pattern, including but not limited to: harm reduction assessment, information, and resources; overdose prevention discussion and training; connecting to community-based recovery supports; scheduling assessments and/or coordinating with treatment facilities; or connecting with Diversion & Recovery Team (DART) for individuals living with substance abuse disorder and experiencing homelessness who are interested in engaging in long-term support for recovery and healing.  

Services for people with Medical Health problems may be: evaluation and treatment of low acuity conditions; medical health education for symptom management; physical assessments; prescriptions; preventive health services; medical clearance; and basic wound care.

Services provided in the broader area of Health and Wellness may be: identifying primary care medical providers, connecting to optometry, dentistry, or sexual health providers; connecting to OB/GYN, pregnancy, or post-partum support; exploring resources for physical movement and nutrition; or connecting to wellness resources for recreation, spiritual connection, and social identity. 

Finally, if clients are looking for Basic Needs, Social Services and Community Resources, they may need referrals for food, clothing, ID, etc.; assistance in applying for insurance, food support, or financial assistance; referrals for vocational  support, waiver services, educational support, or domestic violence and sexual assault advocacy; assistance connecting with shelters, crisis residences, or coordinated entry for housing; or transportation, legal assistance, parenting, and other needs.

Erickson then presented a virtual tour of the  Behavioral Health Intake center on the first floor.   You’ll see more in the You Tube video of this meeting, but the following 2+ minute video covers the matter and emphasizes the welcoming atmosphere the center creates for residents.   Walk-in behavioral health support referrals – social workers – YouTube

The Behavioral Health Center sees itself as “filling in the middle space”.  If someone needs help, but does not have a hospital-level need, or is a public safety issue, this is a great place to start.  People who use the center are not dealing with a medical emergency, a mental health emergency or an overdose, which all require Emergency Room treatment or hospital admission.   Additionally, they must not have committed a crime that requires mandatory arrest and incarceration.   Finally a person must be approaching the Center willingly, that is,  without coercion of any kind. All the services are voluntary.

So  — How well does this work?   

The 2020-2021 data were compiled as a 6-month window looking back and another 6-month window looking forward.   Statistics showed:

  • a 14% reduction in emergency room use,
  • a 10% reduction in inpatient hospital admissions,
  • a 12% reduction in jail bookings,   
  • a 9% increase in community mental health support.

The data were gathered only during the timespan that clients were enrolled in this service.  Other data were gathered from Hennepin County Sheriff’s Office info. There is a limitation that this was a non-experimental design and changes may be due to a variety of factors.

In summary, when someone is in crisis they are suffering and need help right away.  There is no quick fix for any complex issue, including mental health and substance use needs.  All services are voluntary; the center’s mantra is to meet people where they are at.   

If you or someone you know has needs related to mental health or substance use, the Behavioral Health Center at 1800 Chicago is a good place to start. 

Directions:

  • Behavioral Health Center
  • 1800 Chicago
  • Use the entrance off of Columbus
  • Enter the doors marked “Clinic and After Hours Entrance”
  • Open Monday-Friday 9am-5pm
  • For afterhours, use the buzzers to access the crisis residence and withdrawal management

Erickson then shared a brief video that was actually made for law enforcement officers.   https://www.youtube.com/watch?v=vEaQ08tH5nk The MPD Sgt escorting a person to the center explains the procedure he uses. The point is made that the officer may issue a citation or not – it is the officer’s decision.   The Center is a place to bring someone who doesn’t need hospital-level care, and is not creating a public safety issue, but they do need a place where they can get help sorting things out.

The next video is aimed at social workers and is narrated by social workers.   It’s the video referenced above in this report.  Erickson commented that if a person has a care team but has perhaps dropped out of touch with them, the Center will help them reconnect.  If the resident doesn’t have any services in place, the center gets the ball rolling right away, and stays connected with the resident until they are connected to services and supports.  On average, residents are working with the center about a month while they are getting established in longer-term treatment and recovery support.  The center works at the resident’s pace.

The Center website is a source of all the current information you need. Go to: www.hennepin.us/1800-Chicago.  

In the middle of the screen, click on OPEN ALL and you’ll find a detailed list of the info Erickson has laid out in the recording.  The “Recovery Programs” section is particularly worth opening as it adds information about:

  • Diversion and Recovery Team (DART)
  • Project Child
  • Vocational Services Program (VSP)

QUESTIONS:

QQ How many professionals do you have working in that building?

ANSWER:  Erickson listed  the various professional classifications working there and pointed out that this is still an expanding program.  The three facilities have separate staff and two of them run four multiple shifts.  There are staff such as office support, case management assistants, social workers, senior social workers, advanced practice practitioners, medical assistants, registered nurses, and supervisors. 

QQ While the center serves all of Hennepin County, what about people who are farther out, like Eden Prairie, Rogers, Bloomington?  

ANSWER:  We are on a busline, which is good news.   Any law enforcement agency can provide transport and help people get in.   The system has an embedded social worker in many of the precincts, and the embedded social work program is expanding in 2022.  Additionally, if someone comes to us and needs reconnection with their health care provider, we’ll find them what it takes, be that a ride, a bus token, or a scheduled medical ride. 

QQ Do you work out in the community?  

Erickson pointed out that she is only going into detail on the Behavioral Health Center at 1800 Chicago, which is a site-based, walk-in service.  And yes, there are many other parts of Hennepin County Human Services working with the community, including but not limited to:

  • Cope – providing assistance for psychiatric emergencies through phone and in-person consultation
  • Downtown Improvement District Social Workers – engaging and connected residents to needed services and supports from the 120+ city blocks of downtown Minneapolis
  • Jail Diversion Social Workers – connected residents to services and supports to prevent unnecessary bookings
  • Homeless to Housing (H2H) – social workers assisting those experiencing homelessness or housing instability
  • Mental Health Center – provides therapy, psychiatry, diagnostic assessments, and medication management

QQ Is there a lot of turnover in staff. 

ANSWER:  Erickson has been in her current position for 14 months.  During that time, they have been building services and expanding staff.   People come in knowing what their jobs will be, and what responsibilities will look like.  These are people who want to be working on-site.  We’ve been lucky to find employees that want to be part of this.  Like so many agencies in the community now, some are having hiring challenges with overnight shifts, nursing and medical care, and higher level licensed employees.

QQ:  A new Mpls. resident commented she had no idea of the depth of services offered at 1800.   It seems like it’s all relatively new.  Is this more robust than it was?

ANSWER:  The Behavioral Center has gone through many iterations over the years.  We have plans to continue expanding access to these needed services.  The Behavioral Health Center is filling in the middle space, when a resident needs assistance, but doesn’t meet hospital-level criteria and it is not a public safety emergency.  Other states have called this a “stabilization center.”  We will be expanding the walk-in services to a 12-hour day, M-F 9am-9pm soon (website will included updated hours), and eventually into a 24/7 program. 

QQ:  How do you get the word out?

ANSWER: Traffic comes to us from a variety of sources including: law enforcement, EMS, Minneapolis BCR, mental health and substance use service providers, as a step-down from hospital-level care when emergent needs have been met; people are escorted to the facility by friends and family, and by resident/peers sharing their experience of receiving care in this center.  We have a communications team that shares out the website, video, social media, and earned media. [EQ:  You are strongly encouraged to share this report AND/OR the recording of the meeting, which is a YouTube video  https://youtu.be/K6fdIvdHn78   ]

At this point HC Attorney Okoronkwo and Probation Officer Ihrke stepped in to say thanks to Erickson and her teams for making their work easier to do and better for their clients.  

Emilie Quast, Board member

MPD Second Precinct Advisory Council (2-PAC)

e-quas@umn.edu

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