Eastern Iowa mental health access centers off to a slow but promising start

More than five years ago, leaders in Johnson County started working to address an unmet need in the community.

The problem was that there were too few appropriate resources for folks going through crises related to mental illness or substance use. Jail cells and hospital beds are expensive and sometimes counterproductive solutions. There were some treatment options available, but they were not the kind of programs where people in need could get immediate help.

This year, two new centers opened in Linn and Johnson counties to fill that gap. As early backers of the idea, we are excited to report their progress.

They are meant to be a one-stop shop where people in crisis can get immediate care and get linked up with longer-term services.

Both of the new facilities — the Linn County Mental Health Access Center and the Johnson County GuideLink Center — have gradually phased in their operations since opening. They both offer crisis triage and stabilization, sobering units and referrals to other providers with plans to expand.

The Johnson County center is open continuously while the Linn County center is open weekdays from 8 a.m. to 10 p.m. Leaders at both organizations say the biggest barrier to adding services and capacity has been the workforce shortage.

“The ultimate goal is 24/7/365 but if we can't do that in a safe manner and be effective, we're not going to push it,” said Erin Foster, director of the Linn County Mental Health Access Center.

Access centers have been on the rise nationally in recent years as a response to urgent mental health needs and provide an alternative to criminal punishment for some public order violations. They are meant to be a one-stop shop where people in crisis can get immediate care and get linked up with longer-term services.

The Iowa Legislature in 2018 passed a law setting state guidelines for access centers. Linn and Johnson are among 10 now operating across the state.

Access centers as alternatives to jail have taken on greater relevance since the police accountability protest movement last year. There is a strong interest among much of the public to limit the role of law enforcement and jails in dealing with handling mental illness situations. Police are not mental health counselors or substance abuse specialists.

The Johnson County center has accepted law enforcement referrals since it opened in February. Law enforcement is the second biggest referral source, behind hospitals.

“We wanted to work out the kinks with law enforcement first. … Law enforcement has been behind this for years,” said Abbey Ferenzi, director of the GuideLink Center.

The Linn County center recently started taking law enforcement referrals and has seen only about 30, which organizers hope will grow next year. Advocates are making the case to police departments and sheriff’s offices that bringing subjects to the access center is easier than taking them to the hospital.

“The biggest part of buy-in for them is you can bring people to us and we can triage and get people to services, or you can sit and wait sometimes hours in the ER with someone and they may or may not get served. This is efficient and it's getting people the help they need,” Foster said.

Foster and Ferenzi are collaborating on outreach to law enforcement in the seven other counties in the same mental health region.

“There’s definitely more work to be done because we're such a new concept. It’s hard even for our local law enforcement to understand. To stretch beyond that takes a lot of consistent messaging,” Ferenzi said.

In discharge questionnaires in Linn County, clients are asked what they would have done if the access center wasn’t available. More than two-thirds say they wouldn’t have done anything.

“They were in a moment of crisis and if this place didn't exist they would have continued to be in a crisis, wouldn't have sought any other treatment,” Foster said.

While this is just a start for the two centers, it’s clear they already are doing crucial work to meet community needs.

(319) 398-8262; editorial@thegazette.com