With mental health illness, trust vital to recovery
On her bad days, Leslie Weiss had no hope of ever enjoying life.
“With that, you have no ambition, you don’t eat, you don’t dress, you don’t get anything done and then you beat yourself up because you’re not getting anything done,” said Weiss, who has struggled for several years with bipolar disorder.
The Twin Lakes, Wis., resident – who previously lived in Ringwood – has seen the same therapist in McHenry since 1999. Sticking with the same therapist, whom she trusts, is key to her recovery.
About 20 percent of the population is estimated to be dealing with some sort of mental illness, some treatable with medication, some chronic, according to the U.S. Surgeon General’s office. In McHenry County, that would mean more than 60,000 people could have a mental illness.
The National Alliance on Mental Issues defines “mental illness” as a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning. Illnesses include depression, schizophrenia, bipolar disorder, obsessive compulsive disorder, panic disorder and post-traumatic stress disorder.
Those diagnosed with mental illness have different types of support in McHenry available to them – even with the closure nearly a year ago of Family Service and Community Mental Health Center – and finding the right fit is important for working toward recovery.
Weiss, for instance, makes the 40-minute drive each way every Wednesday from Twin Lakes, alternating between group therapy in Woodstock and one-on-one sessions with her therapist.
“This works,” Weiss said. “If I had some other serious illness, I want the best care there is.”
She started taking group therapy when she was hospitalized twice for five days, first in November 2008 and then in May 2010, at Centegra Specialty Hospital in Woodstock-South Street Campus.
“When you’re sitting in a room with people struggling with the same issues that you’re struggling with, they say, ‘I know how you feel,’” Weiss said.
Mental illness spans a broad spectrum, said Brett Wisnauski, president of the McHenry County Mental Health Board. Some diagnosed with a mental illness might have a short-term problem that needs medication. Others might be chronically ill and difficult to treat.
And many face hurdles in the path toward recovery. Medications can be expensive, and some people may stop taking prescriptions – even if they work – once they feel better, Wisnauski said. Others stop if the side effects are bad, and many resort to illicit drugs or alcohol as a means to feel better.
Those seeking inpatient treatment in McHenry County go to Centegra Specialty Hospital in Woodstock, the county’s only inpatient mental health facility for adults. Children and adolescents requiring inpatient mental health treatment have to go outside the county.
The inside of the behavioral health unit is not like most hospitals. Doctors and nurses wear dress pants and shirts, and patients are in regular clothes instead of hospital gowns. Patient rooms don’t have oxygen connections, telephones, televisions or any cords.
“The rooms are modified so they are safer,” said Lori Sullivan, the clinical nurse manager for inpatient behavioral health for Centegra.
Adults at the behavioral health unit stay five to six days in a structured environment, with patients meeting in groups and going through different therapies, such as art therapy, pastoral care, nutritional education or exercise therapy.
Patients meet with a staff member, and have an assigned social worker and discharge planner to help determine the services needed after leaving the unit.
But, as is the case with many medical services, costs are a constant problem.
It costs Centegra $8.5 million annually to run the unit. Dr. Sheila Senn, Centegra vice president and site administrator for Centegra Hospital Woodstock, said a number of patients in the behavioral health unit don’t have insurance.
About 41 percent of the Behavioral Health patients have Medicaid or are self-pay, so they are either uninsured, do not name an insurer or choose to pay out of pocket. That’s a significantly higher percentage of patients when compared to the rest of the health system, which is just 16 percent, according to Centegra officials.
Despite revenues often not covering expenses, Centegra officials say they are committed to meeting the community’s needs.
Centegra is helped by the McHenry County Mental Health Board, which provides funding for those without insurance. Senn said the board contributed about $500,000 last year alone. But the funding from the county doesn’t cover all of the loss.
“There’s been a lot of comment about the value of the mental health board,” Senn said. “From our perspective, in our community, people are able to access services because of the funding.”
So few beds
Not many hospitals have behavioral health inpatient units as, from a business perspective, the units usually run a loss.
When Dr. Chandra Vedak, medical director for Horizons Behavioral Health, is on call at Centegra, finding a bed for a patient can be difficult.
“There are times I see that the crisis worker has called 22 hospitals to find a bed for patients who have come to the emergency room,” Vedak said. “The number of mental health inpatient units have closed down because of resources.”
A May 2011 study by the Illinois Hospital Association found that the number of licensed psychiatric beds in the state has decreased from 5,350 in 1991 to 3,869 in 2010.
Having 24 inpatient beds at Centegra is better than nothing, and without it, patients would be in the emergency room or on a medical floor, Senn said. Some wait three or four days for an available bed.
“It’s really terrible,” Senn said. “Unfortunately, we’ll have people waiting here because we don’t have a bed, and no one else does.”
A person in crisis might be able to get medication in an emergency room, Sullivan said, but no other treatment. And they need the highest level of treatment, she said.
“The ultimate reason they need inpatient care is because they’re not safe to be at home,” Sullivan added.
Many people with mental illness opt for treatment through outpatient facilities, such as seeing a psychiatrist or using local social service agencies.
Horizons Behavioral Health is one such organization. In 2008, Centegra sold it to a group of psychiatrists, including Vedak.
When Centegra owned Horizons, it was losing $1 million to $1.5 million a year, Vedak said. It costs about $3 million a year to run Horizons. Although challenging, Horizons continues to stay afloat.
“We asked them to run the outfit ourselves, and they agreed,” Vedak said. “Centegra has been pretty good and continues to provide the services; they are essential services. I don’t know if they would have closed down the practice or not, but we didn’t want to get to that stage.”
The level of help a person receives, regardless of where they go, needs to be determined by an initial assessment. A person wouldn’t necessarily jump right into inpatient care, said Todd Schroll, interim executive director of the McHenry County Mental Health Board.
The push is to move toward community-based care, Schroll said, with the length of treatment depending on the severity of the illness. Caregivers help with stabilizing the crisis and figure out proper coping strategies.
“We truly believe recovery is attainable, it’s an expectation of care and that’s what we promote as a mental health board,” Schroll said.
Weiss had to go through four to five combinations of medication before determining which set helped her. Her keys to dealing with mental illness are having a therapist she trusts and the right combination of medications.
“I go out of my way to do what’s right for me,” Weiss said. “Part of why I’m doing so well is my disorder is something I manage.”
She hasn’t had a crisis in two years.
“It is possible to recover,” Weiss said. “You live with it and deal with it on a day-to-day basis.”