Illinois seeks 'bold change' in mental health treatment

Posted11/20/2016 7:20 AM

Illinois wants to pursue a new approach when it comes to Medicaid spending that supporters say will improve its treatment of mental health and substance abuse patients.

If the state's application for a waiver to federal Medicaid rules is approved, $2.7 billion would be invested in a five-year span into integrating physical and mental care, and helping patients lead more stable lives.


"It gives you the opportunity to innovate," Felicia Norwood, director of Healthcare and Family Services said. "It's not to expand the reach of Medicaid. It's to better serve individuals in the Medicaid system who have mental health issues."

Illinois has applied for the waiver in the past without much success, but Norwood and suburban mental health care leaders say they are optimistic it could be granted this time, given the state's financial situation.

The application was submitted to the federal government at the end of September, and the state expects a decision next month.

If the waiver is granted, it could mean expansion of programs already employed in the suburbs that integrate physical and mental care, improve access to physicians, create alternatives to emergency rooms for people in mental crisis, and connect inmates with mental health and addiction services before they're freed.

First, the state would aim to improve training so more doctors are qualified to provide mental and physical care in the same setting.

"We've done a horrible job of cutting off the head and treating it in a mental health center when we know (mental and physical care) are both tied together," said Rick Germann, executive director of the Alexian Brothers Center for Mental Health in Arlington Heights.

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Doctors who could handle both mental and physical ailments include primary care practitioners and psychiatrists, with the latter using expanded technology to provide "telepsychiatry" visits for patients in rural areas.

Germann said the new focus would be welcome because several suburban mental treatment centers have had to cut psychiatrists due to cost concerns. He said that's detrimental because it's key to identify patients early, get them an appointment with a psychiatrist, educate their families and provide case management so they don't end up "in a downward spiral."

The state also hopes to decrease the number of people with mental illness or substance abuse who return to prison, as officials are aiming to do in Lake County.

In September, the county began to offer medication-assisted treatment to heroin or opioid-addicted inmates while they're still in jail. In the voluntary program, up to 15 inmates will be able to receive injections of a drug called naltrexone, which blocks the effects of opioids for 28 days. When these inmates are ready for release, the jail will schedule their next injection at the health department so they know when and where to go to for continued treatment.

"They'll feel connected to the community before they even get out of jail," said Susan McKnight, substance abuse program coordinator. "They'll know they have supports here."

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