Moline mental health services trying to catch up to demand

In April, Mayor Sangeetha Rayapati sent a letter about her concerns to UnityPoint Health — Trinity about emergency mental health care in the community. She also read that letter during an April council meeting.

She said she has worked closely with Police Chief Darren Gault to understand the challenges and community needs when it comes to addressing mental health crises in the community. Her letter details frustrations regarding mental health emergency treatment services and those services not meeting city officials’ expectations.

“Our community deserves better emergency treatment for mental health care,” Rayapati wrote in her letter.

Rayapati told the Dispatch-Argus/Quad-City Times that as of July, the letter was acknowledged in a meeting with the hospital officials, but has not been addressed beyond that.

In an e-mailed statement to a reporter, UnityPoint Robert Young Center President Dennis Duke acknowledged the high demand for mental health care and that the center remains committed to doing everything it can to address the demand.

“We understand there is a high demand for mental health care in our communities,” Duke wrote. “We remain committed to addressing that growing need and are doing so by continuing to recruit qualified mental health care professionals and offering a wide range of mental health, substance use disorder services and crisis services for children, adolescents and adults.”

The Robert Young Center, part of UnityPoint Health, provides care for mental health, substance abuse and crisis services for people of all ages in the Quad-Cities and Muscatine. Duke said a Mobile Crisis Unit responds to mental health emergencies in the community and often works with local police, first responders and hospital emergency personnel.

The center is a registered 501(c)(3), nonprofit organization. The Robert Young Center receives funding from Rock Island County. The county 708 Mental Health Board enables the county to collect and allocate revenue for mental health, substance abuse and developmental disabilities services for citizens in the county.

Moline city officials sat down with the Dispatch-Argus/Quad-City Times to discuss challenges in addressing mental health crises and where more resources are needed.

Before sending a first responder, QCOMM911 screens calls to determine the needed response. The dispatch center is located in the Milan Municipal building and provides services for four police departments and nine fire departments in Rock Island County, including Moline police and fire.

Deputy Fire Chief Travis Noyd said dispatch takes the call, gathers information and sends whichever city departments are needed. But figuring out what is going on, Noyd said, can be difficult since it doesn’t always provide the full picture of what EMS personnel could be walking into.

A majority of calls that come in, Gault said, police tend to respond first unless there is a known medical issue. If it is a mental health allegation or an unknown, he said, an officer is dispatched since there is no one else to respond.

When at scenes, Gault said, officers also will assess if someone else has been harmed, what type of behavior is being shown and what other dangerous signs they might be displaying. The most officers can do, he emphasized, is assess the situation, talk with the individual and try to get them “going in the right direction” of professional help.

Some cases are more obvious than others, Gault said, where the individual might be talking erratically and behaving outside of social norms. Whereas there are other situations where it requires more talking to assess what is going on in order to try and help them so they can get the help they might need, he said.

“There are situations we recognize when someone needs emergency care,” Gault said. “(But) we are not medical doctors.”

If or when there is a situation where professional help is needed, Gault said the Robert Young Center has a number public safety personnel can call for a mobile crisis unit.

The mobile crisis unit, Duke wrote, responds to mental crises or emergencies in the community and will often work closely with local police, first responders and hospital personnel. The goal of the crisis team is to provide the “most appropriate level of care and ensure the person’s needs are met in a mental health crisis,” he wrote.

“Team members may provide pre-screening assessments or act as helpers when inpatient hospitalization may be appropriate and connect an individual with additional resources through Robert Young Center,” Duke wrote.

One of the challenges when first responders arrive on scene can be knowing what to expect. Addressing mental health crises, Gault said, requires two parties to participate — the officer and the person needing help.

Determining the state of the individual, Noyd said, also can be a challenge since it depends on the what they are experiencing. One of the first things EMS personnel will do when on-scene, he said, is make sure the individual is stable so they can talk and that there is no threat to themself and personnel on-scene.

“Our safety and the patients’ safety comes first,” Noyd said.

If there is a serious threat, he said, EMS personnel will enact a tactical retreat.

Fire personnel are trained for EMS and are continuously trained, but there are not any specific requirements when answering a mental health crisis-related call, Fire Training Officer Jerry Sottos said.

Sottos said personnel will ask the individuals questions to try and figure out what is going on but the challenge also can become trying to convince them to go to the hospital. 

Moline Fire Chief Steve Regenwether and Noyd said the most EMS can do is encourage them to get help and get them to the hospital if they so desire. People experiencing mental health crises and transported by Moline public safety personnel are brought to the emergency room at UnityPoint Health – Trinity in Rock Island.

Illinois officers, Gault said, have undergone training for de-escalation and addressing mental health crises. When someone calls emergency services and an officer is dispatched — no matter the situation — an officer(s) is going to respond and handle the situation as best as they can, Gault said.

“We are here 24/7 — police are in every community,” Gault said.

Society, Gault said, has always had a mental health crisis and society’s philosophy and more openness of discussing it has rapidly changed.

And with no one else to really dispatch when these calls come in, he said, it leaves law enforcement more often than not in the middle trying to do what they can. 

Speaking for his officers, Gault said they want to get people the help they want or need but get frustrated with not being able to solve it. Officers can’t force someone to seek care, he said, and can only talk to and with them and try to guide them in the right direction.

“We are often applying a Band-Aid to a much bigger wound,” he said. “Officers can not solve the problem alone.”

Noyd said when he first started, mental health wasn’t something that was openly talked about and more something people put on a shelf and let it sit there. In order to recognize mental health issues, he said, it’s something that needs to be addressed.  

Gault acknowledged they have good, trusting partners but that there also needs to be a “major shift” in crisis care and a change in the Quad-Cities to better handle and address the growing needs of mental health care.

The COVID-19 pandemic only exacerbated the issue, he said. As the discussion around mental health has become more open and needs to address it has increased, he said, issues have arisen with funding, staffing and the resources needed to address it for public safety personnel and the health system. 

Robert Young also has faced similar challenges in trying to meet the growing demand. Workforce issues, Duke said, have been their greatest challenges to meet the growing demand for care.

In August 2021, Gov. JB Pritzker signed the Community Services and Supports Act, or CESSA, into law. The legislation requires emergency response operators at 911 centers to refer calls seeking mental and behavioral health support to a new service that can dispatch a team of mental health professionals instead of the police. The change goes into effect in July 2025.

Gault, who sits on the board for CESSA of Illinois Region 2, said officers would only be dispatched if there is a threat of violence.

According to the legislation, law enforcement will only be dispatched if the individual is involved in suspected violation of the criminal laws of this state or if they present a threat of physical injury to themself or others.

And as lawmakers work to change years of regulations and rules to better address mental health needs, he said, the issue also becomes a service problem in which institutions can not change that fast.

“It was like this perfect storm,” Gault said. “Society changed, laws changed, yet services still haven’t caught up.”

Duke and Noyd also are on the CESSA Region 2 committee. Duke is serving as the 590 provider co-chair and Noyd is an EMS provider representative on the committee, according to the Illinois Department of Human Services. 

The legislation also establishes statewide committees in each EMS region to work out on the ground logistics of how services will be provided based on local services availability. 

Also in Rayapati’s letter, she acknowledged the “significant economic pressures that health systems face” but goes on to say that the Quad-Cities region is not “ripe with options” and the emergency room at UnityPoint – Rock Island is the “primary entry for Moline citizens to seek such care.”

“We recognize the need is great and we want to continue to find solutions with partners so our community can continue to lead healthy lives,” Raypati told the Dispatch-Argus/Quad-City Times.

Rep. Gregg Johnson, D-East Moline, also mentioned the possibility of incentivizing providers and offering scholarships, essentially a “grow our own network of behavioral health providers.”

Duke said they do have internship programs for counseling and social work students in partnership with regional education institutions such as Western Illinois University, University of Iowa and St. Ambrose University. They also partner and collaborate with six area school districts to provide school based mental health services, he said, such as counseling and psychiatry for students identified with the highest needs.

When Sen. Mike Halpin, D-Rock Island, sat down with reporters from the paper to talk about spring session, he highlighted federal funds the Robert Young Center was awarded.

The governor’s office announced in June that the Robert Young Center in Moline and Rock Island received federal funds in the Certified Community Behavioral Health Clinic Medicaid Demonstration Program. The program aims to expand and improve access to coordinated mental health care and substance use services.

The program also provides reimbursement through Medicaid for the full cost of services that CCBHCs provide.

Johnson, said there is a mental health crisis and once one thing is addressed, the next thing needs fixed.

“The boat is leaking from 1,000 different directions,” he said.