Washtenaw County Rallies Around Its Residents
Voter approved millage expands mental health services
—By Michelle Easley
As America starts to loosen mask restrictions and vaccination requirements in response to decreasing Covid-19 numbers, concerns about mental health and substance abuse during the Covid-19 pandemic still remain. Each year one in five adults and one in six youth experience challenges with their mental health. These numbers have been exacerbated by social isolation, increased student work loads, loss of loved ones and other stressors brought on by the pandemic. The mental healthcare system was strained before the pandemic due to a lack of trained clinicians; however, Washtenaw County seemingly got a jump on a looming mental healthcare crisis due to COVID-19.
In 2017, Washtenaw County residents approved the county’s Public Safety and Mental Health Preservation Millage. This millage is a tax to Washtenaw County homeowners that generates resources for mental health and substance use treatment programs. The millage was proposed to improve health and quality of life across the county. It includes funding to programs aimed at keeping those who commit crimes, as a result of a mental health episode, out of the criminal justice system.
One funded program that is making a difference is Assertive Community Treatment (ACT). ACT is a team of psychiatrists, nurses and case managers that provide intensive support as well as medication monitoring for adults with severe mental illness. ACT is a 24 hour/365 day program with on-call services available.
Peer to Peer Support
An integral part of ACT and other supportive services are peer support specialists. The specialists play an often unseen role in Washtenaw County’s mental health organizations. Peer support specialists are individuals who use their past experiences with mental health and/or substance abuse challenges to assist others going through similar ordeals. Specialists attend Michigan’s Certified Peer Support Specialist training program where they learn to help others navigate the healthcare system, obtain critical resources and encourage others on their path to recovery. A number of Washtenaw County organizations, including Washtenaw County Community Mental Health (WCCMH), University of Michigan Addiction Treatment Services, the Ann Arbor Veterans Affairs Health Care System, and Packard Health employ peer support specialists.
University of Michigan Alum John Krisel, LMSW, is feeling the brunt of a strained mental healthcare system and welcomes the assistance of peer specialists. “It’s a really good idea,” he said. Krisel, a clinical therapist who provides telehealth sessions out of his private practice, now sees patients 7 days per week due to increased demand for mental health treatment. “I’ve been serving the mentally ill for over 32 years and I have never seen it this bad,” said Krisel. “The pandemic has increased mental illness and crime across the entire spectrum. Domestic violence is up. Drug use is up. Incidents of suicde have increased. Depression, anxiety, all of it. And I’m treating more children, more working professionals and more students than ever.”
Some students at U-M have experienced how a mental health crisis can indirectly affect them. One student, who requested to remain anonymous, said one of his professors left in the middle of the semester to address their own mental health concerns. “While I applaud their decision to make their health a priority, their absence created a lot of stress on me,” he said. “We had several substitutes and different grading scales. The whole thing left me very anxious and confused.”
Still other U-M students like LSA junior Shayna, reported struggling academically without really knowing why. “I’m not as motivated as I used to be.’ Shayna reported. “I may be depressed but I’m not sure.”
The struggle is real
None of this comes as a surprise to Krisel. “Mental health struggles can present in many ways. Often a person who seems angry, lazy, overly excited or who is constantly laughing could be experiencing a mental health crisis,” says Krisel “There isn’t a one size fits all symptom, like excessive crying, that points to a mental illness. The signs can mimic any number of emotions. For students, it’s important they pay close attention to any differences in their mood and tell someone.”
College students seek mental health treatment for a myriad of reasons, mood changes, inner restlessness, crying spells, etc. Many University of Michigan students seek services at the Counseling and Psychological Services (CAPS). A referral to CAPS is listed on nearly every U-M course syllabus and provides the student’s first and often the only source for mental health services on campus. CAPS provides confidential psychological services for enrolled U-M undergraduate and graduate students. Students can call CAPS or they can schedule an appointment online. But as many students have discovered, the wait time for an appointment often exceeds a week. CAPS is not equipped to handle severe mental illness or situations that require an immediate clinical evaluation. It is in these situations that Washtenaw agencies can provide referrals to local hospitals or provide immediate help to students.
Krisel accepts college students who reach out to him for therapy services. “There is a pandemic of college students, young adults who struggle with their mental health,” he said. “It is a true public health crisis.”
The 2021 peer-reviewed report by the National Academies of Sciences, Engineering, and Medicine entitled “Mental Health, Substance Abuse and Wellbeing in Higher Education,” echoes Krisel’s assertion. The report calls for “substantial improvement” for institutions of higher learning to help students saying “more purposeful engagement by postsecondary institutions” will help curb some of the stressors that students experience while in college. In order for students to reach their full potential and thrive in college, they must have a feeling of mental stability and wellbeing.
The millage creates a new partnership
The Washtenaw County Sheriff’s Office (WCSO) and Washtenaw County Community Mental Health (WCCMH), with funding from the millage, collectively adopted new police reforms. The Sheriff’s office and WCCMH each supported a joint public safety and mental health millage to prevent some of those residents who needed mental health treatment from entering the criminal justice system. The millage has created a partnership that fuels better reforms.
The reforms allow the two agencies to work hand in hand to “prevent those with behavioral troubles from overburdening the court system,” says Patrick “Pat” Chase, probation agent at the Mental Health Court in the 15th District in Ann Arbor. Chase attends conferences with the Michigan Association of Treatment Court Professionals (MATCP), an organization whose mission is to “provide leadership to treatment courts in the State of Michigan.” Chase notes, “The state of Michigan as a whole is making great strides to support a new model of justice for the mentally ill.” sharing that they learned other counties have emerging programs to help their residents but the problem was “very, very complicated.”
As a strong proponent of the millage, Chase said they have witnessed a “sharp decline in court surveillance and jail sentences for the mentally ill in Washtenaw County.”
One key part of the reform effort was the institution of Law Enforcement Assisted Diversion/Deflection (LEADD), which is an evidence-based pre-booking diversion model that began in October, 2021. The goal of LEADD is to “redirect individuals away from the criminal justice system and into community-based supports.” These services are available to any resident in Washtenaw Country including U-M students, faculty and staff.
2020: A year like no other
During a time of uncertainty, with cruise ships docked, schools closed, stay at home orders in place, and a lack of essential items to address toiletry needs, many communities charged with caring for Covid-19 patients, offered less service to the mentally ill. Washtenaw County was not one of those communities. Instead, Washtenaw County forged onward by continuing to provide a full complement of mental health services. In 2020, when mental health needs surged nationwide, Washtenaw County was able to answer the call due to funds provided by the Public Safety and Mental Health Preservation Millage. As other communities found themselves understaffed and underfunded, Washtenaw County was able to increase access to mental health services for residents.
According to Washtenaw County’s 2020 millage impact report, the millage provided hotel rooms for mentally ill homeless residents during the onset of the pandemic. In addition, they were offered expanded supportive services such as food, counseling and clothing. Community partnerships received increased funding in 2020 and a new stabilization center called 750 Tower, which provides a temporary space for those in crisis, opened in the midst of a global pandemic.
The millage provided funding to substance use disorder services for county jails. Following extensive research which shows that medication-assisted treatment (MAT) is an effective way to treat substance use disorders and likely reduces recidivism, Washtenaw County’s MAT program served 36 people in 2020. The program helped them recover from substance use disorders while serving their sentences.
Mental illness affects different groups of people (students, first responders, the elderly, healthcare workers, marginalized populations) differently in terms of its severity and nature. Professionals dedicated to providing mental health and substance use disorder services often find themselves burnt out due to the critical need for services and professionals versus those who are qualified to provide treatment. Along with healthcare disparities, 2020 illuminated the need for comprehensive mental health services and reform. With the support of residents, hospitals, law enforcement and other community agencies, Washtenaw County is leading the charge in innovative services for all residents experiencing mental health and substance abuse challenges. If you or someone you know is struggling emotionally or has concerns about their mental health, there are ways to get help.
- For medical emergencies, call 911.
- Washtenaw Crisis Services provides 24/7 phone and mobile crisis services to any Washtenaw County Resident and can be accessed by calling 734-544-3050.
- The Psychiatric Emergency Service (PES) at Michigan Medicine is available 24/7 to determine what may be appropriate for you and/or your loved ones. Call 734-936-5900 for a phone consultation.
Feature photo by Dan Meyers on Unsplash