Safe Haven

A new Mary Greeley-managed facility expands community mental health services.

By Steve Sullivan

Darrell Robinson planned to work for Mary Greeley Medical Center’s Behavioral Health
program for five years and then move south.

That was 35 years ago. He’s still here and has been a psychiatric assistant at Mary Greeley’s Transitional Living Program (TLP) facility since it opened near the hospital in 1995. Robinson finally made a move in October, but not far. He’s now at Mary Greeley’s new Transitional Living Center (TLC), which opened a few blocks away from the hospital.

“The value of this program is priceless,” said Robinson, who has helped countless people move on with their lives after facing significant mental health challenges. “This is what the community needs to help those with mental health issues and those who
are not capable of advocating for themselves.”

Mary Greeley’s TLP was the first program of its kind in Iowa. All of the experience and expertise gained through TLP now shifts to a more significant program at the TLC.

“TLP has been the model for similar programs in Iowa. Providers from throughout the state have toured this program to see how it works,” Robinson said.

New Facility

The TLC is a cooperative effort of Mary Greeley, Story County, and the Central Iowa Community Services mental health region, which covers 11 counties. It is located at 124 S. Hazel Street in Ames. Mary Greeley oversees the program.

The TLC provides care and support services to persons who have a diagnosis of mental illness or co-occurring diagnosis with mental illness and substance abuse. The TLC fits into the continuum of mental health services by providing crisis or transitioning care for adults in a less restrictive setting at a lower cost, said Jen Barber, TLC coordinator.

Dr. Usha Chhatlani, a psychiatrist with Mary Greeley’s Behavioral Health Unit, is the center’s medical director. The center is staffed with psychiatric assistants from Mary Greeley, including Robinson, who are trained in working with adults with mental illness in a supervised, community-based setting.

It will be for people 18 and older who are referred to the TLC by a provider from Mary Greeley, or from other medical and mental health provider locations.

Levels of Care

The TLC has eight beds and provides two levels of care: crisis stabilization and transitional living. Two beds are designated for crisis clients, and up to six are available for transitional living.

Crisis stabilization care is for clients who are experiencing a mental health emergency such as increased mental health symptoms or emotional distress. Although these clients are in crisis, it is not so severe that they need to be in an inpatient setting, said Barber.

This is one of the biggest benefits of the center, said Chhatlani. By having a place for people in crisis, it frees up inpatient beds for patients who might be facing more extreme mental health issues.

“We are very fortunate to have this facility, given the increased need for psychiatric care we see in the community right now,” she said. “There are different degrees of crisis in mental health and sometimes people in crisis don’t always need to be in the Emergency Department or an inpatient unit. This facility will provide a safe place for people who can stabilize in a few days in a less restrictive setting.”

Individuals needing this level of care will typically be in the facility for up to five days, during which time a safety stabilization plan will be established.

Individuals will meet with a licensed mental health provider each day to review their plan and connect with resources.

Transitional living care is intended for individuals who have been in crisis and are now stabilized but need more time to get supportive resources in place, such as housing, employment, and ongoing counseling services. The goal is for individuals who have been hospitalized for mental health treatment to have services in place to successfully transition them back to their communities and avoid rehospitalization. The length of stay at this level of care is up to three months.

Referral Required

The TLC is not an intake center. A provider’s referral is necessary. Someone in a mental health crisis should first go to their provider or to the nearest Emergency Department. Referrals are coordinated by contacting Mary Greeley’s Behavioral Health inpatient unit at 515-239-2682. While other agencies can refer a client to the TLC, a medical screening will be required before they can be admitted.

The state’s mental health regions can provide payment for either level of care. The TLP is seeking accreditation through the Department of Human Services. Once received, payment will be sought through Medicaid for crisis care. Payment for crisis care by private insurance is not widely established at this time. Private insurance does not pay for transitional living. Only the mental health regions fund this level of care.