Joan Hartman recently took over as executive director of the nonprofit McLean County Center for Human Services (MCCHS), located in downtown Bloomington. That's the agency that provides behavioral health resources to residents with the greatest need and fewest resources.
Hartman was formerly vice president of strategy and public policy for Bloomington-based Chestnut Health Systems, where she was previously vice president of behavioral health. She also previously provided oversight of psychiatric residential services for First Hospital Corporation in Norfolk, Virginia. At MCCHS, Hartman succeeded Tom Barr, who retired.
Sound Ideas host Sarah Nardi recently spoke to Hartman about the most pressing issues facing McLean County.
WGLT: When it comes to mental health, what's the county’s most pressing need?
Hartman: That is a very large question. And I think the biggest piece is just access to services. We have so many people in our community who have need of services for the whole range, between counseling, psychiatry – and so many of our kids also have need of counseling services, too. So I would say access.
The county just released an updated mental health action plan. How well positioned do you feel, given the terms of that plan, to address these problems of access?
I think we have providers in the community, including the center, who have the ability to address the needs of the community in general. I think every one of those needs could be addressed by one of the providers, including the center.
I think the reason why they haven't in the past has to do with funding, and being able to pay for those services, especially for individuals who don't have any form of payment, including Medicaid or private insurance. And so I think that with the appropriate funding allocated to us, we could fill the majority of the needs that have been identified.
Probably the one thing that that we would need to put our heads together around would be the housing for people with mental health disorders.
Is that a piece that's been missing?
That’s a piece that we as a community have struggled with for quite a while. Here at the Center for Human Services, we have 18 units where we house people with mental health disorders and provide support services while they're housed at their apartments. And we could expand that, with appropriate funding. We could certainly expand that. And it really is a successful program that enables people to stay in their own apartments and get the services that they need right there in their apartments to be able to take care of their activities for daily living, and to be successful out on their own.
How much more funding would it require for you to be able to deliver the kind of services in that area that you feel the community needs?
That is a very good question. I don't know that I have that all like mapped out yet. Because there's a combination of rental assistance … because most of the people that need housing are people who don't have full-time jobs, can't pay six $700 a month in rent. So there would be the need for some rental assistance and then need for assistance in salaries – underwriting some of the salaries of staff that would be able to be on site and provide services.
What that speaks to is a need for a holistic approach to mental health and behavioral health, something outside of sitting down with someone for an appointment once a week, and once a week might even be aspirational. Do you think that people in the community are coming around to the understanding of just how comprehensive mental health care needs to be?
I think so. I don't know if, like, my next-door neighbors, people who are not in the helping profession or in the medical field, actually understand it. But I think that as a community of health care providers, including medical and wellness providers, and people providing behavioral health services, we certainly understand the fact that we have to come together and look at it as a whole person, and to be able to look at and address everyone’s social determinants of health, whether you have a mental health disorder or not.
It becomes especially important, though, for those people with mental health disorders, because those social determinants of health are what keeps them either out on their own and independent or in need of hospitalization or intensive services.
Nationwide, before the pandemic we were seeing an uptick in mental health and behavioral health needs. And then of course, the pandemic just compounded all of that. Has there been any comedown in terms of what we've seen as a result of the pandemic?
I think that people with insurance are able to access their primary care, and their primary care docs in our community have been really great about taking care of or helping with individuals who have had depression or anxiety related to the pandemic.
I think, though, there are individuals who still need services, especially psychiatry services, whose disorders have become larger than what a primary care office is able to take care of. And I think that that's still a hole in our community.
And we have a shortage of psychiatrists in the community, right?
Yes, we have a definite shortage of psychiatrists and psychiatric APRNs (advanced practice registered nurses), who are wonderful and fill a huge void for us.
And the key component there is they're able to prescribe medication?
Yes, right. Yes, that is the key component.
On youth mental health, this also seems to be something that's gripping the nation in terms of a real increase in in younger kids needing services. Where do we stand here?
I think that we're headed in the right direction. I think psychiatry for children and adolescents is still a huge need for us because we still have families that are going out of town for services or having to access services via telehealth and have long waitlists.
In terms of counseling for students, we have partnered with both District 87 and Unit 5 through funding from the county through the (Regional Office of Education, or ROE) to provide on-site, embedded … what we call the Embedded Schools Programs. Which means that our clinicians are right there in the school, just like regular school staff, and getting referrals and being able to see kids right there at school. Rather than having the burden on parents of having to pull them out of school, take time off of work to get services, which for some parents is impossible.
