Medical director brings her passions to new GuideLink Center

IOWA CITY — Dr. Monika Jindal always knew she wanted to pursue a career in medicine.

She thought about specializing in pediatrics, but that changed when she began doing her clinical rotations in medical school. She said a feeling in her heart pulled her toward psychiatry and mental health care work. When she wasn’t doing that work, Jindal realized she missed it.

“I think some of those moments kind of came together to make me realize that this is something I truly feel very passionate about,” said Jindal, 36.

Jindal is trained and boarded in both family medicine and psychiatry and has practiced both since she’s been out of residency. Her interest is to provide mental health care as broadly as possible and find innovative ways to deliver that care — such as at Johnson County’s new GuideLink Center, where she is the medical director.

She graduated from the University of Cincinnati College of Medicine in 2011 and completed a five-year residency program at the University of Iowa. After completing her residency, Jindal moved to Denver, Co., for three years before returning to Iowa in early 2020.

“I got lured back probably mostly by GuideLink Center, to be honest,” Jindal said. Jindal and her husband also were ready for a change as they thought about starting a family and wanted to be closer to Jindal’s family in Ohio.

Jindal is also an assistant clinical professor and the associate program director for the family medicine and psychiatry residency at the university. Most recently, she was appointed by Gov. Kim Reynolds to the Council on Human Services.

“It just felt like medicine was one of the things where the person always came first, and as long as you knew you were doing something right by the person, that was like the be all and end all,” Jindal said. “I think for me, that's what's always been most interesting about medicine but also most rewarding.”

Continuing to expand

The GuideLink Center, a $6 million mental health and substance facility years in the making, has been open for more than six months. The 24/7 center provides sobering, crisis stabilization and detox services.

After a soft opening in February, the facility at 300 Southgate Ave. in Iowa City gradually expanded its services and beds and began to accept walk-ins.

The GuideLink Center had a total of 455 patient encounters from February to August, Executive Director Abbey Ferenzi said. About a third of those were walk-ins, with the remaining being referred to the GuideLink from outside services such as health care providers, law enforcement or mobile crisis outreach.

The number of individuals using the center’s services has been gradually increasing according to data presented at the September advisory board meeting. Sobering had 68 total admissions from May to August. Crisis stabilization had 192 admissions from February to August. Detox had 102 admissions from June to August.

“Each one of those numbers, especially when you talk about admits or people that we are providing crisis counseling to, that's a life,” Ferenzi said.

There also has been an increase among walk-ins, according to data. There were 64 during August — almost double of what the center saw in July.

“I don't think we will ever feel like we're done,” Jindal said. “I think we're always going to have things that we want to work on or projects that we can do to make it better or services we want to expand.”

“We haven’t even reached half of our potential or capacity,” Ferenzi added.

The center is working on expanding its number of beds, as well as opening crisis observation. Ferenzi said the center has the capacity to have 12 individuals on any given night — a number that can be doubled. She said the goal by the end of the year is to have the full capacity available.

“I'm excited about serving more people because what we have found is the more beds we open, the more services we open … every time we increase something, we see incredible things happen,” Ferenzi said.

But one of the biggest hurdles to accomplishing those goals is staffing. Crisis observation needs nursing staff to observe patients around the clock.

“The staff that we have here are phenomenal. They are working as a team, they are collaborating, they are thinking outside of the box, but we need more of them,” Ferenzi said. “Besides the pandemic and all the other things I can say, there's just a national kind of staffing shortage across the board that we're battling with right now.”

Ferenzi is also looking forward to expanding outreach to college students and being a resource to young adults who are experiencing mental health issues.

The UI is in the process of hiring a student care coordinator who will provide support and follow-up services for students who have had crisis intervention or hospitalization, UI spokeswoman Hayley Bruce said. The position is funded by the UI Department of Public Safety.

“That position will be a wonderful link to university students,” Ferenzi said. “This person isn't just working to connect people to GuideLink Center, but that's a big portion of it because I think the university seems very invested in helping students have another option besides the emergency room, especially if they're having suicidal thoughts or an onset of psychosis or something like that.”

Ferenzi encouraged people to learn about the center and its services because it’s not there just for medical professionals who refer patients to the center — “it’s for family members, it’s for your friend, it’s for a co-worker, anyone who needs that urgent-type care.”

Jindal added that GuideLink is a “safe place for people to land when they’re in crisis.” And if GuideLink isn’t able to help an individual because a higher level of care is needed, then staff will work to find the right place.

Working with the state

Reynolds visited the GuideLink Center in February, along with Department of Human Services Director Kelly Garcia and Lt. Gov. Adam Gregg.

During that visit, Jindal outlined three areas where the state could assist this new health care model: financial viability, maintaining a high-quality workforce and improved access to care through an integration of services.

Six months later, Jindal said there has been follow up conversations, with Garcia being in “close contact” with Jindal and Ferenzi.

Jindal said the state has been helpful as the center tries to think through specific exceptions to the code for using a paramedic instead of a nurse, for example, or other similar circumstances. Jindal said the state has been helping with these case-by-base scenarios.

Another potential change Jindal brought up is how ambulances aren’t able under state regulation to bring patients to GuideLink Center instead of to a hospital emergency room. Jindal said the response from the state was a need to look into the Iowa Code more. While it hasn’t been resolved, Jindal said it’s encouraging that it’s being discussed.

With her appointment to the Council on Human Services, Jindal said she will be able to share what’s happening on the ground in Iowa City with mental health care professionals and the GuideLink Center, and continue to discuss some of these policy changes.

Jindal said she feels thankful to be able to do this work and work with Ferenzi and the staff at the GuideLink.

"I'm very grateful to a lot of people,” Jindal said. “I'm really grateful to Iowans and our patients. They’re doing this every day and living these really hard lives. I'm just honored that they let us be a part of it.”

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