Transformation through transition: Providing mental health care in a supportive setting

Brian had his first mental health emergency in 2005 when he was 42 years old. He held a physically demanding job as a pedicab driver on the West Coast, often working as many as 16 hours a day. And then, one day, he started hallucinating.

“I didn’t know what to do except tell people I was having high anxiety,” he said.

Over the next eight years, Brian was hospitalized six times for his episodes, each stay lasting several weeks. Each time after Brian was released, he refused to take his recommended medication.

Finally, in 2010, Brian came to Minnesota to visit his father and brother, who until then had believed Brian was stable. But within four days of his arrival, Brian was back at the hospital, where he stayed for three weeks receiving treatment for anxiety.

Housing is a critical need for people experiencing mental illness

Like Brian, individuals with mental illnesses or substance abuse disorders often find themselves released from the hospital without care and support to help manage daily life. Minnesotans suffering with mental health issues or substance abuse disorders face long-term barriers to living in the community. Many need help finding housing, as they may have a difficult rental history, and the housing market is already a tough terrain to navigate.

Others simply can’t afford housing, said Jayne Quinlan, director of community services at HealthPartners.

“Most of our patients with long-term mental health needs are on disability or Social Security and have limited incomes, so they are priced out of the housing market,” she said.

Fortunately, Brian had somewhere to go: a transitional care facility.

HealthPartners currently offers three unique transitional care programs designed to help patients with mental health issues or substance abuse disorders move out of a hospital setting back into the community. The programs help patients develop a healthy, stable path – and, when needed, continue to support them as they manage their daily lives.

Intensive Residential Treatment Services needed in communities

The Safe Alternatives program, funded by a grant from Ramsey County Adult Mental Health, allows Regions Hospital to locate and maintain housing in the community for more than 200 people with mental illnesses each year. It helps patients navigate housing subsidy programs, resolve tenancy issues with landlords and more.

The Safe House, where Brian stayed, is a nine-apartment Intensive Residential Treatment Services (IRTS) facility staffed 24/7 with social workers, therapists and nurses. It gives residents a safe, supportive environment where they can work to become successful members of the community. On average, patients stay at the Safe House for around 60 days.

Hovander House is another IRTS serving approximately 270 patients a year, but unlike the Safe House, it serves as a crisis support center. Patients stay between three and seven days while they transition to the next level of care. Meals are provided, and while the patients choose how to spend their days, each is responsible for meeting with the staff daily and for working on individual goals.

A recent study conducted by Wilder Research for the Minnesota Hospital Association showed that there is a shortage of IRTS facilities in communities throughout Minnesota. These treatment centers are needed for when mental health patients are discharged from hospital stays.

By helping patients gradually transition from a stay at the hospital back into everyday life, the programs aim to provide a compassionate community for individuals when they need it most. The programs have shown a 90 percent reduction in participants being admitted back into the hospital.

For Brian, the biggest benefit of staying in the Safe House was having a community of people around him and knowing that he wasn’t alone. He’s also grateful that he had caring nurses who oversaw the administration of his medication.

“It was eight years until I was convinced I should take the medication,” he said.

With the help of these programs, Brian has been stable for three years. He takes his medication faithfully. He volunteers at a local church and school. He’s even studying for the LSAT in the hopes of entering law school next year.

“I was fortunate in that I had a place to stay,” said Brian. “It was helpful. It reinforces the idea that there’s a community of care.”