Professionals concerned about potential consequences
PEORIA — Peoria Heights resident Tamra Antenucci is one of many residents falling through the cracks in the network of mental health services.
She’s had trouble getting help for herself and her 15-year-old son.
“To get him with an actual psychiatrist, I was told it’s going to be 12 to 15 months,” she said. “I have advocates through the Autism Collective, which is through Easterseals. They work with teenage kids and they try to get you the resources you need. She sent me a list of different resources for autistic ADHD children and the ones that take Medicaid were all 12-month waits in Peoria. There were a bunch that were only one-week waits, but that was if you had really good insurance, or could pay full price.”
Antenucci doesn’t know how she is going to wait 12 to 15 months.
“I get calls from his school almost every day on him either having a meltdown, or rebelling or getting overstimulated. And a lot of times I can’t even get him to go to school,” she said. “My son isn’t usually like this and something’s going on. I hate seeing him struggle.”
The most vulnerable are at risk
Long wait times are typical for mental health services in Peoria, which, like communities across the U.S., is affected by the growing national shortage of psychiatrists. In the entire state of Illinois, there were only 480 psychiatrists in 2021, according to statista.com. And as is often the case, there are fewer options for people on Medicaid.
“Our most vulnerable are not being taken care of,” said Kim Keenan, a licensed clinical social worker specializing in psychiatry. “Every time there is some national news, like a school shooting, I’m like, ‘Oh, my God, this is going to happen here.’ I’m telling you, something’s going to go down, and that’s when everybody is going to be like, ‘Where are our services? What are we doing?’ And those of us who have been doing it for so long, none of us will be surprised.”
People with financial means and health insurance are generally able to get the help they need, though they may have to leave the area to get it. But people without insurance or those on Medicaid are falling through cracks in the system, said Keenan. She worked specifically with low-income populations before leaving her job in May as the Certified Community Behavioral Health Clinic program director at UnityPlace.
While Keenan points to the national psychiatrist shortage as a key factor in the problem, she said issues within UnityPlace, the behavioral health arm of UnityPoint Health, have made the problem worse.
UnityPoint Health has been the hub for mental health services in central Illinois for many years. Today it has 39 programs, including outpatient programs, community-based programs, residential centers and hospital beds. When it joined forces with the Human Service Center and Tazewood Center for Wellness in 2019, there was much fanfare, but the results of that venture have been less than optimal, said Keenan.
“When they brought those organizations together is when you saw the first of the decay,” she said. “They hired a president to come in who only stayed about 18 months, and he pretty much revamped the whole senior leadership.”
Management issues have led to poor employee retention, which has had a detrimental effect on patient care, said Keenan, who has worked in behavioral health in central Illinois for more than 20 years. She left her job at UnityPlace out of frustration after about six months. She now works for OSF HealthCare.
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While UnityPoint Health officials declined to talk about personnel issues, UnityPlace President Mary Sparks Thompson said the company is working diligently to hire additional behavioral health staff. Thompson became president of UnityPlace in January, filling a position that had been vacant since Ted Bender departed in June 2021.
“We are focusing a lot of our efforts on recruiting from our psychiatry residency program, and we’re seeing some gains in that regard,” said Thompson. “We’ve also had some benefactors locally to assist with workforce development, and that’s allowing us to offer stipends for residents who commit to continue their work here and to do some other kinds of financial incentives to secure an early commitment and to reward continued service in our community.”
The behavioral health industry faces many challenges nationwide, said Thompson.
“We just don’t have enough people to provide the service, and that’s all the way from entry-level staff all the way through our psychiatry colleagues,” she said.
The challenges facing behavioral health facilities are complex, said Thompson.
“In the ’70s, state hospital beds were depopulated to provide services in the community, which was a laudable goal, but we didn’t offset that with enough beds in the community, we didn’t have enough inpatient services, so there is a pent-up demand for those services,” she said. “So it comes down to the number of providers, it comes down to a reduction in the number of beds, and on the hospital side of things, reimbursement has been historically low. It’s hard to run the services in a financially solvent way. And it’s a difficult type of service to run. It’s a lot different than running a medical surgical unit. For example, you have to staff it differently, the patient population is a little different, the care deliveries are different. So sometimes that creates extra challenges for hospitals as well.”
Dr. Sam Sears, a psychiatrist and the director of Behavioral Health Physician Services for OSF HealthCare, is critical of the state of Illinois’ handling of key psychiatric services.
“I would say that there are very few other states that have as much abandoned their state support for mental health inpatient services to the degree that Illinois has,” he said, citing the state’s closure of Singer Mental Health Center in Rockford in 2012 due to budget cuts. “There are still facilities around the state, but most of the beds the state still runs are pure forensic psychiatry beds for people that are in the criminal justice system that are being evaluated for whether or not they can stand trial. The state still has some civil beds, but the vast majority of their beds are forensic beds at this point.”
With all the challenges the industry was already facing, the pandemic only made things worse, said Sears.
“Basically, we started out in a slight apocalypse in the mental health world, and then the pandemic broke out,” he said. “A number of physicians across all specialties decided that maybe this is my time to exit stage left and retire,” he said. “And I’m sure you’ve read the statistics, the pandemic increased rates of anxiety, depression and substance use issues.”
Centers for Disease Control and Prevention statistics through 2021 revealed a 30% to 40% uptick in those mental health issues, said Sears.
“The scariest statistics that were coming out of that was for the general adult population, one in 10 had seriously thought about suicide in the previous month, and for kids it was closer to one in four or five.”
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A glimmer of hope
Both OSF HealthCare and UnityPoint Health are working to address the shortage of behavioral health services by opening new facilities in central Illinois.
In October, OSF announced a plan to partner with US HealthVest to build a 100-bed behavioral health hospital in north Peoria that is slated to open in late 2024 or early 2025. The facility will bring much-needed beds for inpatient care — currently, only UnityPoint Health has inpatient psychiatric services in Peoria, forcing many people to leave the area for care.
“Given that Methodist is always full from their own patients, essentially every one of those 50 to 60 people we are sending out every month is basically going to Bloomington-Normal, Champaign or Ottawa or Dixon or up to Chicagoland, because we send them to wherever we can get beds available. And even then, there are times when people are waiting for days to find an available bed,” said Sears.
The new hospital will also attract more medical professionals specializing in psychiatric care to central Illinois. US HealthVest has a good track record when it comes to keeping its facilities staffed; it is a for-profit hospital system, which means it is able to offer higher salaries than the nonprofit OSF HealthCare, said Sears.
“Nonprofits have a standard at which they have to pay based on what’s a standardized fair market value, and that limits how high we can go in total cash compensation without risking our nonprofit status,” said Sears. “A for-profit can pay whatever the market actually demands to get an individual to say ‘yes.’ So, traditionally, our partners have done very well in being able to staff their providers across their hospitals.”
UnityPoint Health is focusing on care for children and adolescents in the new facility it is opening in the old Heddington Oaks nursing home in West Peoria. The Young Minds Program will provide much-needed beds for inpatient care. In the last five years, 2,600 children seeking inpatient services at Methodist Medical Center have had to leave the area to get the care they needed. The new facility will also provide many outpatient services.
Helping central Illinois residents get the services they need without leaving home is an important goal of both projects. In the end, it will undoubtedly provide better outcomes, said Sears.
“We know better continuity of care happens when you’re more local. We know that families are able to be more involved and friends are able to be more involved and supportive when they’re getting their care closer to home.”
Leslie Renken can be reached at (309) 370-5087 or [email protected] Follow her on Facebook.com/leslie.renken.