Southlake Center FOR MENTAL HEALTH
This issue:
Semi Independent Living: A Highly Successful Program
Bell Tower Apartments: A Model Community Assertive Community Treatment Team Brings Treatment to the Client 24 Hour Emergency Service: 769-7200 24 Hour Emergency Services (219) 736-7200
Southlake Center FOR MENTAL HEALTH 8555 Taft Street Merrillville, Indiana 46410 (219) 769-4005
2
SOUTHLAKE CENTER for Mental Health Board of Directors 2007-2008
Lee C. Strawhun, MPA President/CEO
Sherry Oman, RN, MS Vice President, Clinical Administration
John Kern, MD Vice-President, Clinical and Medical Affairs and Medical Director
Info for You! is published for Southlake Center FOR MENTAL HEALTH quarterly by Geminus Corporation in collaboration with the Southlake Education Committee - Chairperson: Winnie Mycka Editor: Barbara Markle Southlake Center for Mental Health 8555 Taft Street, Merrillville, Indiana 46410 (219) 769-4005
3
Semi Independent Living Program: A Highly Successful Program by Stan Ladowicz, Director of Southlake Center for Mental Health has been operating a Semi Independent Living Program (SILP) for over 20 years. The Semi Independent Living Program serves two purposes. First, it provides individuals affordable housing. Second, it is a costeffective way of serving individuals who need some level of support, but not the 24 hour care provided by supervised group homes. When the program first started, Southlake Center worked with local landlords and housed two individuals in two-bedroom apartments. The program was highly successful for a number of reasons. First, the program allowed for greater independence. Second, it was less costly than group home treatment. Third, clients could afford the cost of the apartment that is subsidized by the Indiana Division of Mental Health and Addictions. Finally, it allows individuals to integrate into the community. It is very rare that a SILP Program has a opening.
Center for Mental Health made their first attempt to obtain funding through HUD applying for funding through Mainstream Housing Opportunities for Persons with Disabilities. This program improves
Depending on the needs of the individual, Community Assistance Specialists meet with individuals in their apartments, teaching them to cook, clean, manage money, obtain needed benefits, build better community support and problem-solve as needed.
the stock of Section 8 vouchers and is earmarked to individuals with serious mental illnesses and other individuals with disabilities. Although HUD approved the application, programs were awarded money based on a lottery and Southlake Center was unsuccessful in the lottery. Southlake then applied for the same grant in 2002 with the same results.
Affordable housing in Lake County, Southlake’s traditional service area is a very significant problem. Most one bedroom apartments in the south Lake County area average over $600 per month. On the other hand, individuals who have serious mental illnesses and are unable to work full time heavily rely on Social Security Benefits. In the summer of 2001, Southlake
However, in June of 2002, Southlake submitted a HUD Section 811 grant designed to provide affordable housing for individuals with disabilities. The grant had two important components. First, funds were available to build a facility and secondly, funds were available to subsidize the cost of rent in
Community Assistance
the facility. Therefore, resident would have a place to stay and pay no more than 30% of their income for rent. On November 18, 2002, Southlake was awarded the grant. During 2003 Southlake Center worked with an architect and builder to plan a 14 unit apartment building with a manager’s unit. Southlake continued to explore additional funds and applied for and was awarded a second Section 811 grant, before ground was broken. In January 2004, while the first project, Watertower East opened its doors, Southlake Center was completing its third grant application and was awarded a grant for the Bell Tower project. This project has just opened its doors. In less than five years, 42 one-bedroom apartments were built and Southlake Center for Mental Health is hoping for a seven year plan, ready to submit another grant this summer which would add 14 more apartments. Stan Ladowicz, Director of Community Assistance asked residents what they thought about their apartments. One resident noted, “I didn’t have hope; I now feel alive. I have friends in the building!” Ladowicz reports that the biggest high for him is issuing residents the keys to their apartments and seeing their smiles, but he laments, “ We still do not have enough affordable housing and people are waiting and hoping. I don’t want to disappoint them!”
4
Assertive Community Treatment Team Brings Treatment to the Clients In the early part of the 1970s, a state hospital was closed near Madison, Wisconsin and a small revolution in community mental health started. At that time, community mental health centers were starting but few had services beyond out-patient treatment.
Many individuals discharged from the state hospital never made it to the doors of the community mental health center. Therefore, a group of creative individuals conceived the idea of bringing treatment to the clients. Although social workers at state hospitals had been working with clients in the community, two ideas were different. First, the funds needed to help clients followed the client into the community. Second, with this funding, a team of people worked together to treat this small group of individuals coming into the community. Each member of the treatment team had a specialty to contribute to the treatment of the clients in the community. In an era when the medical profession was phasing out house calls, psychiatrists
were actually seeing patients in their homes. Beyond a psychiatrist, the team had other professionals including a nurse, therapist and case managers. The team met daily to obtain assignments.
Dr. Helen Lin, a staff psychiatrist for many years joined the team shortly afterwards. Dr. Lin had prior exposure to the ACT model in Chicago during her residency in psychiatry and has a passion for working with individuals with serious That describes the first Assertive Community Treatment Team: called ACT mental illnesses. Shortly afterwards, a pair of case managers joined the team. for short. The ACT model is now an internationally recognized method of The ACT team treats about 40 to 50 treatment for individuals with very serious clients at any given time. It is not and hard-to-treat mental illnesses. designed to treat the general population Countless articles have been written but a select group of individuals who documenting the success of the model. It have severe problems difficult to treat in is one of a small handful of treatment a traditional mental health setting. models that have been designated by To qualify for ACT team treatment experts as evidence-based treatment. individuals must have a recent hospitalization at a state hospital or multiple psychiatric hospitalizations at community psychiatric hospitals. Or, individuals may have been in jail due to “The ACT model is now an internationally psychiatric-related reasons or had recognized method of treatment for individuals multiple encounters with law with very serious and hard-to-treat mental enforcement officers. Finally, individuals illnesses. that have been recently homeless qualify. Typically, these are people that fall through the cracks of the community mental health system. In the autumn of 2004, Southlake Center for Mental Health was awarded a small grant by the Indiana Division of Mental Health and Addiction to start an ACT team. Dr. Laura Moseng agreed to supervise the team and she has been at the helm ever since that point. Dr. Moseng had years of experience working with a variety of clients, including individuals with serious mental illnesses and addictions.
Southlake Center FOR MENTAL HEALTH is accredited by
The Joint Commission
5
So, what is the average week like for an ACT client?
Some clients are ready to take on vocational preparation or work but need support. Lucinda works with individuals in Supported Employment Model.
Typically, he or she will see three or more staff members in any given month. The client is likely to see Dr. Lin for medication and see a case manager for a variety of tasks that I will discuss shortly. But here is where the uniqueness of the ACT program starts: if a client has a co-existing medical condition or has a hard time taking medication, Barb Fransioli, RN, the ACT nurse is available to monitor a variety of medication/medical issues in consultation with Dr. Lin. Suzanne Albright, the Substance Abuse Therapist, may work with indi- The ACT team from left to right: includes: viduals with co-existing problems with drugs and/or alcohol. Suzanne works with those individuals Like ACT and IDDT, Supported Emranging from those who are thinking of ployment is an evidence-based treatquitting to those who are managing a plan ment program. In the later stages of to abstain. this model, Lucinda Franco locates emSuzanne and the rest of the team have been training in another evidence-based treatment program called Integrated Dual Diagnosis Treatment or IDDT, for short. The IDDT model is based on treatment individuals at the level of change and helping them move to another level by using motivational strategies. In addition, the IDDT model does not artificially separate psychiatric problems and substance abuse problems, but treats the whole person.
ployment and may work side-by-side with the individual until he or she can do reasonably well performing the job independently. This method helps to bridge the difficulties that seriously mentally ill clients often encounter in obtaining and maintaining employment. Finally, individuals may see Carol Briggs or Laura Moesing for individual therapy. Therapy may include problem-
Cognitive-behavioral approaches to help manage and reduce symptoms.
The backbone for ACT is case management. It is not only the psychiatric issues that lead to negative outcomes for the seriously mentally ill. Very practical issues such as food, housing, benefits, and social support networks are vital to successfully manage a client’s illness. Some individuals are unable to work and require assistance in obtaining and keeping benefits such as food stamps, Medicaid and Social Security. In some cases, we act as the client’s representative payee and help them to manage their social security checks. Some clients need help with cooking, cleaning and making appointments As one case manager put it, “I do a little of everything to keep people going!” For clients, it is often a word of encouragement and someone to count on that helps the client to get through the pain and agony of their illness.
Bell Tower Apartments: A Model Community Bell Tower is the third of three HUD projects with “tower” in the name. Anything “tower” at Southlake means apartments. So, you will not find an actual tower at Bell Tower. The theme for the building comes from the Clarion Bell, a symbol for the Mental Health Association, now called Mental Health of America. They uses that symbol because a bell was built using some unusual material. In the nineteenth century, the state hospital was considered the state-of-the-art treatment for persons with mental illnesses. Many of these individuals were shackled using wrist and leg irons like prisoners. With the philosophy of benevolent care for these citizens in the community, the need for shackles no longer existed.
As a symbol of this new philosophy, shackles were melted down to create a bell. May the bell ring crying out for the right of the mentally ill to have a rightful citizenship in the community! But, the battle is not ended. Prejudices about mental illnesses continue to create new shackles. May Bell Tower serve as a model that the seriously mentally ill can live in harmony with the community.
6
New & Noteworthy Lake County Public Library • Mental Health Resources Taste of Home’s Budget Suppers By Jean Steiner
64 1. 55 2 T AST
Money-Saving Meals By Maureen Powers
64 1. 55 2 M ON E
500 Simple Money-Saving Ideas By Joel Martin
64 0. 42 M A RT
10 Minute Guide to Household Budgeting By Tracey Longo
64 0. 42 L O N G
I Can Do It! I Can Do It! Housekeeping Hints for People with Very Special Needs By Barbara Cox
64 8. 5 C OX
Eliminate Chaos: The 10-Step Process to Organize Your Home & Life By Laura Leist
64 8. 8 LE IS
Talking Dirty Laundry with the Queen of Clean By Linda Cobb
64 8. 1 C O BB
Conflict Resolution: Communication, Cooperation, Compromise By Robert Wandberg
30 3. 68 WA N D
Friendly Advice (Life Skills—Quotations, Maxims) By Jon Winokur
08 2 WI N O
7
The Burden of Sympathy: How Families Cope with Mental Illness By David Karp
36 2. 20 42 2 K AR P
Helping Someone with Mental Illness: A Compassionate Guide for Family, Friends, and Caregivers By Rosalynn Carter
61 6. 89 C A RT
Understanding and Treating Borderline Personality Disorder: A Guide for Professionals and Families By John G. Gunderson
61 6. 85 85 2 U ND E
New Hope for People with Borderline Personality Disorder By Neil R. Bockian
61 6. 85 85 2 B O CK
Psychotherapy with Borderline Patients: An Integrated Approach By David M. Allen
61 6. 85 85 2 A L LE
Borderline Personality Disorder Demystified: An Essential Guide for Understanding and living with BPD By Robert O. Friedel
61 6. 85 85 2 F RIE
Coping with Schizophrenia By Evelyn B. Kelly
61 6. 89 82 K E LL
The Complete Family Guide to Schizophrenia: Helping Your Loved One Get the Most Out of Life By Kim Tornvall Mueser
61 6. 89 8 M U ES
Understanding Psychiatric Treatment: Therapy for Serious Mental Health Disorder in Adults ByGerald O’Mahony
61 6. 89 1 U ND E
“Helping. Healing. Building a Stronger Community.”
8
Southlake Center FOR MENTAL HEALTH
8555 Taft Street Merrillville, Indiana 46410
Lee C. Strawhun, President and CEO Phone: (219) 769-4005 Barbara J. Markle, Editor, Phone: (219) 757-1904 VISIT US ON THE WEB WWW.SOUTHLAKECENTER.COM
Southlake Center FOR MENTAL HEALTH - More Locations
Child and Adolescent Services
Southlake Center Associates
1409 East 84th Place
1348 Lake Park Avenue (Indiana Route 51)
Merrillville, Indiana 46410
Hobart, Indiana 46342
794-2000
942-4040
Southlake Center Associates 290-A East 90th Drive Merrillville, Indiana 46410
736-9115
To be removed from this mailing, or to make a comment, feel free to call the editor at (219) 757-1904