Detroit Wayne Mental Health Building Crisis Center near Boston-Edison neighborhood
The problem is this: Serving an additional 40,000 people in downtown Detroit and transporting people for services in Livonia can be inconvenient and a barrier to care, said Eric Doeh, the network’s acting CEO.
Quite often, Detroit police or family members bring Detroit residents requiring a behavioral health assessment to the emergency room at DMC Detroit Receiving Hospital. Like many busy hospital emergency rooms, psychiatric patients are waiting for care, a classic example of the national problem of psychiatric boarding of emergency patients.
“It’s not just law enforcement, we have family members and others who are experiencing these struggles and challenges and struggles,” Doeh said. “We need a place here (in Detroit) accessible to people.”
Besides Hegira’s COPE in Livonia, there are only three other crisis centers in Southeast Michigan: Common Ground in Pontiac and centers operated by Washtenaw County Community Mental Health in Ypsilanti and Macomb County Community Mental Health in Clinton Township and St.Clair Shores.
Team Wellness Center also operates a 24-hour crisis stabilization unit at 6309 Mack Ave. in Detroit under contract with DWIHN. Two years ago, Pine Rest Christian Mental Health Services in Grand Rapids opened an urgent psychiatric care center.
After several years of planning, DWIHN plans to open a two-story psychiatric and addiction crisis center in the fall of 2022 at a cost of between $10 million and $15 million, which includes building renovations, furniture and equipment costs, Doeh said.
DWIHN’s board of directors, which authorized renovations to the building to begin, has yet to give final approval for a planned bank loan to fund the project, he said. The network’s annual budget was $835 million in 2020. Funding comes from Medicaid and Health Michigan (87%), federal grants (2%), and other state grants and contracts.
The 25,000 square foot center will be located in a century-old former post office near the Boston-Edison and North End neighborhoods at 8726 Woodward Ave. It was formerly used by New Center Community Mental Health, a now-closed provider. agency.
DWIHN could open two more in the coming years, said Brooke Blackwell, the network’s chief of staff.
“Long term, it’s the best option to get more,” Blackwell said. “It puts people’s needs first and takes a lot of the stress off local emergencies.”
When open, DWIHN’s Crisis Assessment Center will include a five-bed, 23-hour adult sober living unit in the basement; a 15-bed short-term adult residential unit on the second floor; and an 18-bed crisis stabilization unit, 12 beds for adults and 6 for children on the first floor.
“It will be the first of its kind as it will consolidate all services under one roof,” Blackwell said. “The Crisis Stabilization Unit is there to accommodate people who can come in, dropped off by law enforcement by the emergency units to get that professional and mental health assessment.”
Blackwell said adults and children can then be referred for psychiatric treatment or hospitalization, if a bed is available. Wayne County’s only Children’s Crisis Stabilization Unit is located at DMC Children’s Hospital of Michigan.
“We will work with hospitals and our community partners to triage them on an individual basis,” Blackwell said.
Doeh said the additional element of DWIHN’s new crisis center will be the longer-term adult living unit where people can stay longer than the 24-hour maximum, the state limit on detention of people before transferring them to a hospital psychiatric bed, residential or outpatient care.
Sherry McRill, visionary director of behavioral health agency CNS Healthcare in Waterford, said there were not enough psychiatric inpatient beds available for critically ill and chronic patients.
“Crisis centers are really important” because of the lack of inpatient psychiatric beds and mental health stabilization resources, McRill said. “People need to be assessed, and not everyone needs to be in a hospital bed. It’s very traumatic to end up in a psychiatric ward. And once you’re there, there’s chances are you’ll be back.”
Crisis centers are authorized by state law to detain people in need of stabilization for up to 24 hours.
“If the police arrest you because you’re on the street and you threaten people, but they don’t really know what’s wrong, (instead of putting you in jail), they can take you to a crisis center and they can assess you,” McRill said. “One of the things that could happen is that you might have some kind of psychotic problem related to an alcohol overdose or a drug problem.
Mental health agencies like DWIHN would like to invest more in mental health crisis centers to draw patients away from busy ERs, allow referrals once patients are medically stabilized, and provide alternatives for walk-in patients. you.
But many barriers exist to mental health crisis care in Michigan. They include lack of reimbursement and outdated state regulations and laws, experts tell Crain.
One barrier is outdated language in the state mental health code that limits the time centers can hold patients in pre-admission screening units to 24 hours after diagnosis, even though there are a legitimate reason of public health and safety. The other prevents specially trained ambulances and paramedics from dropping patients off at crisis centers for assessment. Under state law, people in mental health crisis must be taken to the hospital.
For three years, mental health advocates have worked with state legislators and the Michigan Department of Health and Human Services to update the state mental health codewhich was last modified in 1974.
In early March, the Michigan House approved two bills that would address mental health crisis services. A (House Bill 4043) would require the state to implement an electronic psychiatric inpatient bed registry that would allow agencies to find an adult or child bed. The other (HB 4057) defines the appropriate use of different types of restraints when trying to control a person’s behavior.