DuPage 'Living Room' a calmer alternative for mental crisis help

 
 
Updated 11/20/2016 8:10 AM
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With muted lights, soft music and floor-to-ceiling windows, the Living Room is designed to be an oasis -- a deliberate contrast to the emergency rooms many of its guests have frequented.

Operated by the National Alliance on Mental Illness in DuPage County, this room, at the health department community center in Wheaton, invites guests to talk as much and as openly as they want about the mental health crises that brought them to the new facility seeking help and hope.

"We help them relax," said Thomas Mitchell of Naperville, a peer specialist at the Living Room, which opened in October 2015. "We let them just talk and get it all out."

The Living Room is an example of where Illinois might be headed in how it treats those with mental illnesses, if the state is granted a waiver from federal Medicaid rules.

The waiver would allow the state to redirect money typically applied to existing programs and use it to integrate physical and mental health care, improve access to psychiatrists, connect jail or prison inmates with mental health and addiction services before they're freed, and create more alternatives to emergency rooms, which can be jarring to people in crisis.

Taking these steps to improve mental health and addiction care for the roughly 800,000 Medicaid members in Illinois who have such conditions could enhance their ability to earn a living and be self-sufficient, reducing the strain on other safety net programs, state health officials say.

Peer specialists such as Thomas Mitchell meet with guests at the Living Room, hosted by the National Alliance on Mental Illness in DuPage County. They say the facility offers a calmer alternative to an emergency room for people in mental health crises. The state could try to increase the number of such facilities if its application for a five-year waiver of federal Medicaid rules is granted.
  Peer specialists such as Thomas Mitchell meet with guests at the Living Room, hosted by the National Alliance on Mental Illness in DuPage County. They say the facility offers a calmer alternative to an emergency room for people in mental health crises. The state could try to increase the number of such facilities if its application for a five-year waiver of federal Medicaid rules is granted. - Bev Horne | Staff Photographer

Before the Living Room, where 139 guests have been treated since October 2015, options were limited for people to get help when a stressful day, a series of triggers or an unknown cause kicked a mental condition into crisis mode, said Angela Adkins, executive director of the National Alliance on Mental Illness in DuPage County.

"It doesn't make much sense to have somebody go to the ER just because there isn't any other alternative for them," she said.

In the emergency room, everything is an effort to save lives and stabilize medical calamities -- even at the cost of exacerbating mental ones, NAMI leaders say.

People in mental crisis often have long waits to be seen. The bright lights, ringing phones, sounding alarms and fast-moving employees can be chaotic in a way that's detrimental to someone with anxiety or psychosis. Plus, advocates say, an emergency room visit at roughly $3,000 is more costly than alternative facilities -- and it's not the best treatment option for someone in a mental crisis.

Chrissy Tobias, left, is a peer specialist at the Living Room in Wheaton, and Patty Johnstone is resource support director. Tobias and Johnstone say the facility is helping people with mental diagnoses realize there is hope even during a crisis.
  Chrissy Tobias, left, is a peer specialist at the Living Room in Wheaton, and Patty Johnstone is resource support director. Tobias and Johnstone say the facility is helping people with mental diagnoses realize there is hope even during a crisis. - Bev Horne | Staff Photographer

"The reason they came is being totally accelerated," Adkins said. "At the Living Room, they're going to be seen immediately, so that instantly helps."

A guest's visit to the Living Room likely will last about two hours, beginning with a risk assessment by a clinician from the DuPage County mental health crisis center and ending with a reassessment to see if symptoms have stabilized. Each visit costs NAMI $300, but the service is free to guests -- and they're all called "guests" instead of "patients" to avoid a clinical feel.

When a guest reports decreased anxiety during the exit assessment, that brings fulfillment for peer specialist Mitchell, 52, who is in recovery from bipolar disorder. He's worked with at least 20 guests at the Living Room, which is open from 3 to 9 p.m. seven days a week, and many stories have mirrored his own.

"The biggest success for me is when somebody walks in hopeless and walks out with some degree of hope," Mitchell said. "We're here to work alongside them to help them help themselves."

That type of support is an example of why Illinois hopes to lessen what the Department of Healthcare and Family Services calls "an overreliance" on large mental health institutions and increase the care provided in communities, where people can be supported by peers like Mitchell as well as family, friends and volunteers.

At the Living Room, peer specialists including 30-year-old Chrissy Tobias of Glen Ellyn provide support by asking open-ended questions about their guest's symptoms and introducing them to services offered by NAMI, such as support groups, peer connections and family groups.

AT DAILYHERALD.COM/MORE: The Living Room at the National Alliance on Mental Illness of DuPage County in Wheaton opened in October 2015 as an alternative to the hospital emergency room for people experiencing increased mental symptoms.In its first year since opening in October 2015, the Living Room has helped 139 guests, only 19 percent of whom have made a return visit during another crisis.
  AT DAILYHERALD.COM/MORE: The Living Room at the National Alliance on Mental Illness of DuPage County in Wheaton opened in October 2015 as an alternative to the hospital emergency room for people experiencing increased mental symptoms.In its first year since opening in October 2015, the Living Room has helped 139 guests, only 19 percent of whom have made a return visit during another crisis. - Bev Horne | Staff Photographer

"You can see that they want to get better," Tobais said. "But they're grasping and don't know where that help is going to come from."

Tobias says she always encourages guests to set an achievable goal before they leave, such as calling their doctor about a new symptom, joining a peer program or attending a support group. Doling out advice reminds her to keep taking positive steps in her own recovery from depression, anxiety and borderline personality disorder, for which she last was hospitalized in 2012.

NAMI leaders want more people with mental diagnoses to know help can come from the Living Room -- not only from a 911 call or a trip to the hospital or an appointment at the doctor's office -- although they do say psychiatrist visits and medication are important elements of recovery.

"We don't want to encourage people to be consistently coming back to it," Adkins said, and so far, most of them have not; 19 percent of 139 guests have returned, but the remaining 81 percent have not needed a second visit. "It's not a drop-in center."

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