Trying to sto revolving door for the mentally ill between treatmen and incarceration in The Cities.

[lively music] [music ends] It has become a shocking statistic about the world some people live in.

Scott County says it has spent more than $7 million over the past five years, and just 17 people.

Those 17 adults, have mental health issues that leave them in a cycle of homelessness and crime that rotates them in and out of courts and jail, often because they mismanage medications and fall into trouble on the streets.

So what to do?

For $268,000 Scott County is launching a program this month.

The Assisted Outpatient Therap Program is a structured, court supported intervention program aimed to stabilize people with serious mental health issues.

These are people who, in the past have been so-called hig utilizers of hospital services, EMS calls and interactions with police and the courts.

So we talked with Lori Elam, director of Scott County Community Services and the lead monitor for the assisted outpatient therapy program.

Beth Stoffers.

Well thank you both for joining us.

We're talking about the Scott County Assisted Outpatient Therapy Program.

Is there anything like thi in existence in Iowa right now?

Currently, there's a program i Johnson County, Iowa City area, and Linn County is looking at creating an AOT program as well.

And it's, it's been established in, in, throughout America.

I mean, there's other programs around.

Beth, le me ask you about that because, because you're kind of reall the point person in so many ways when it come to the success of this program.

You already know who these people probably are that you're going to serve.

We were talking earlier.

I mean, one of the key thing is to try to earn their trust.

Yes.

How do you go about doing that as best you can?

And everybody's individual, everyone's different.

We'll meet them in the hospital after a 2, 229 is, filed, that is committal, we will go up and do an assessment, make sure they're, you know, eligible for the program.

Just if they're difficult, don't understand, can't get don't have the means to get their meds or, you know, don't understand the reason for... The need for this.

Yes.

And so you have to get them to that point.

And we're talking about people who, and tell me the big headline keeps being that we've got like 17 people that have, cost, Scott County $7.5 million over the past five years.

I mean, that just kind of hits you real quickly.

But it's a true statistic, right?

Yes.

Yeah.

The, we had ten providers come together and, come up with a list of names that we all know that we've had contac with over the last five years.

And then we went back to our respective offices and looked at expenses, pulled those numbers out, added them all together and it came to the $7.1 million.

And these 17 people aren't any better off than what they are today.

And so we decided we needed to kind of take matters in our own hand and look at what services do we have in the community that we could expand.

Vera French's Ac program is going, is expanding.

And then we started, Beth and I started investigating AOT, and what it looks like because it focuses on homelessness, incarceration and repeated hospitalizations.

And that's what we deal with every day, especially with these 17 individuals.

Because, Beth, it really is a terrible cycle, isn't it?

It is.

Yes.

And tell me about that, because we're talking about, as we said, the same people.

I almost want to say they can't help themselves.

Yes.

Or, you know, they're repeatedly in jail, they're repeatedly homeless.

They're yo know, businesses are calling us.

We're just trying to help them and find a more quality of life.

Like, you guys, community ser..., centers.

Because when you say businesses call you, it's because of a disturbance or something like that at a business.

Yeah, either they're trespass or they're, you know, maybe trying to get a food for themselves and.

Well, and that tends to be where it ends up being a, police problem.

And let's be honest, I mean, you're a professional dealing with these type of people.

The police departments are better trained at it, but that's not their specialty.

Right.

So the key is, is to the vicious cycle of homelessness, medication problems and incarceration is wha we're really trying to tackle.

What has been the respons by the court system and police?

We've been very fortunate the police department, we have a great collaborative relationship with Davenport PD, Bettendorf PD, and the Sheriff's department.

The court system, seventh Judicial District, the chief judge, Henry Latham has been very supportive of us, and what we've been trying to do.

And so we we have the backing with law enforcement and the courts.

You know they just want the best services for these individuals because they don' need to be out on the streets.

They don't need to be in jail.

Right.

You know, with these individuals well work on helping them find housing, working with landlords, you know, to rent to them.

We can become their payee, protective payee.

If they're on Social Security, we can make sure the landlord's getting paid the first of every month.

We'll help them get their Medicaid back, help them get food stamps.

So they'll have a place to live.

They'll have food, they'll have medicine.

They'll have other medical care that they may need.

They may have diabetes or they may have high blood pressure.

We don't know.

And then getting them to Vera French Community Mental Health Center for their appointments with the therapist or for the med checks, making sure they get there.

And getting to any other doctor appointments.

And our goal is to help them reach some stability and recovery.

That's the word I was going to use.

Beth, is is just to fin some stability for these people.

I mean, so that their feet are solidly on the ground.

I mean, how are you going to be able to do that?

Well everybody's going to have their individualized treatment plan, and we're going to focus on the individual themselves, see what their barriers are.

What they need to stabilize.

So it might be a day to day thing, we're with you.

Well, I think that's really important because a lot of these people have, I think we were discussing it earlier, have burned bridges.

I mean, their families are are at wit's end right now.

Friends have tried and haven't been, and maybe they have bad influence friends, too.

You're going to be trying to be the, the third party truth teller.

Yes.

The builder of a relationship.

How do you think you're going to get through when other people have failed?

I thin just the point of being there.

Some of them may not like us at first, but, you know, they'll get used to us.

We'll be there every step of the way.

We're, you do what you say, you know.

But is that the key, though, where perhaps other programs have failed.

Is that it is 15 people, its as close to one on one, as you're going to get right now and that you will not give up.

And you are trained to deal with them professionally.

Yes.

So, I mean, I guess how long do you keep up with these people?

I mean, it's not like a one off, you know, you can't do it just for a month.

How long would you would you stay in contact with this person?

So the program is designed to meet with them or be with them for 12 months.

Okay.

They could last for 18 months, but that just depends.

Are they ready yet?

You know... And that would be determined by who?

The courts?

...the courts or the treatment team... I see.

Okay.

...the AOT team.

But we're not going t just give up on you like, you're you're not going to... One day you're there the next day youre not.

...right, right, so.

So explain to me your AOT team.

So it consist of the AOT team leader, which is myself, Lori, the AOT director.

We have a AOT peer support, which is through Vera French.

We have the AOT referee which is like a judge referee.

They will, watch the court orders.

That's a lot of people.

Yeah.

Okay.

And then the defense attorney.

Okay.

And AOT once again, Assisted Outpatient Therapy Treatment.

Treatment.

Treatment.

Thank you, I appreciate that.

And so this has to go hand in hand with the court system in order for, in order to make it work, because there has to be somebody saying, this has to be done and that's the courts.

Right.

Right.

They refer to a lot of this as the “black robe effect,” where the individuals come in because we meet with them, the team, every other week.

So it's one on one.

The team meets with them, talks to them about how they're doing, what progres are they making on their goals?

Are they having problems?

What's causing the problem?

Give you an example, somebody may not lik the medication that they're on.

Maybe it gives them an upse stomach or gives them headaches.

Well then let's talk with the provider and see if there' a different kind of medication.

Or maybe there's an injection, an injectable medication that would be better than a pill form.

You know, so we work with the individual to try and problem solve what the issues are and then take it bac to the provider or to the courts or whatever, you know whatever the situation may be.

But the referee, will have an opportunity to give positive feedback and encouragement when they're doing well and they're staying on track, working with Beth working with the peer support, and going to thei appointments, taking their meds, you know, not having wild parties in their apartmen and causing problems or damage, doing, doing the right thing, staying on track with this program.

Well Beth, how do you how do you how do you plan on keeping tabs on the people who are in the program, especially when it comes to, and one of the biggest issues is the taking of medications properly and on a regular basis.

Scott County has a huge collaboration, so we work very well with Humility of Mary which is the homeless shelter.

We have the co-responde who works with Davenport police who has eyes on them.

Genesis, who will be aware of who's in the AOT program.

And we have Act as well.

The Act team are out and about 24/7.

So they'll be supporting us as well.

So some of the support already exists.

Correct.

Yeah So so how how is this different?

Is it because it's through the court system?

Yes.

It's a brand new program.

Never, we've never had it in Scott County before.

But but it seems like all the elements were already somewhat there.

Somewhat, yes.

Yeah.

Exactly.

Yeah.

What do you hope that, it because when the original announcement was made is that you were saying 15 people for the first year with the hope to expand it even further.

How are you going to be able to measure success?

You're really going to do it individually.

And whether or not the person is seeing improvement?

Where, we, have performance measures and outcomes.

So we'll be tracking how many times were they in the hospital prior to joining AOT?

How many times incarcerated?

How many months were they homeless?

Then we'll measure it from the day they start AOT.

Homelessness incarceration, hospitalization.

We're also going to be tracking, adherence to medications.

So we'll be tracking every day, did they take their medicine or not?

So we have a large, spreadsheet of keeping track of the data every day on each of those individuals.

And that's the big difference.

Yes.

Okay.

Explain to me, how big of a problem is this?

Because we're talkin about basically 17 individuals, but the problem is bigger than that, of course, when it comes t mental health in our community.

Yeah, this, the program for AOT, I think Davenport P had mentioned they could come up with a list of 80 people, you know, so we could expand.

Not everybody has the problems as extensive, as extensive as what we're going to be dealing with.

But, you know, it's, it's a struggle when you have mental health issues.

Sometimes the thoughts are disorganized and, the stigma of mental health and, you know, going and seeking help.

But it's getting better.

You know, the messag is out there in the community.

It's okay to seek help.

It's okay to say you're not okay.

And having peer support in our community is tremendous, you know, because that perso has been through the same thing and they can be muc more supportive and encouraging and get the person to come in for help.

Because, we were talking earlier I mean, these aren't stupid people in any way.

They're they're not dumb.

They're very intelligent.

They just have certain issues that that make particularly medication or, or emotional reactions to things a little different.

So, so what, is that what you have noticed with the people that you have dealt with?

Yes.

So these type of individuals that have some severe mental illness, they just sometimes just lack the follow through.

They don't know to go to Vera French, have an appointment.

They don't know they have a court hearing because they're going to wal in a room with tons of people, and they're not going to sit there for an hour and a half.

So AOT brings it back to a one on one basis.

I didn't think of that exactly.

And that be, you know, that can be very beneficial.

Yes.

And we're talking about, when we were talking about these 17 individuals and I keep going back to that number, I know it's more than that.

Is that, a lot of times it's a case of disruption, like you said in a store.

Yes.

Or a public nuisance issue, out on the street, that something has happened, and that's when the police are called.

And that's kind of what happens as far as the genesis of bringing people into the system.

Yes.

So.

So, the idea would be that once they're in the system is to better control what happens from that point forward.

Now, in the past, years ago, you would warehouse people you'd institutionalized people.

That is one of the things that you're definitely trying to get away from.

Well, initially, this whole process started with a discussion about having a smaller locked facility for some of these individuals because we know that they needed their meds, they need structure, they need food, they they need proper hygiene and medical care.

Our institutions, the mental health institutes in the state of Iowa have reduced the number of beds.

And so we obviously we can't send 80 people, you know, to an institution.

So we were, initially talking to the state and to legislators about the possibility of building a locked facility in Scott County.

But it was going to cost way more money than we could ever imagine.

Plus, there's a lot of regulation and code change and all of that.

It just wasn't going to happen.

And so then that's when we started looking at what can we do in our community right now, you know, and that was expanding the Act, looking at AOT, and, you know, working to se if we can make that a reality.

We also looked at some mobile units to help folks, you know, going out into the community and meeting them where they're a to make sure they got their meds and get their blood pressur checked and that kind of thing.

So kind of being creative and looking at what do we have in our community and how can we expand that?

And we've done very well with this.

Yeah.

I mean, the key really is kind of the one on one.

I mean, if they know you, they trust you, they better understand you.

And we're not talking about really necessarily violent people.

We're just talking about people that are just in and out of the jail system.

I'm talking about what is it, 200, some 230, $250,000 for this program?

Our budget for this first year is $262,000.

Okay, a little over a quarter million as compared to we keep throwing around that $70 million.

Yes.

So you're looking ahead has really a cheap, good investment.

Yes.

Yeah.

And it's and it's bare bones I mean we have one of Beth.

We have one peer specialist.

One of me, and so you know we are going to do the best we can.

That's why we have to limit the number of people coming into the program the first year.

Our goal, obviously is we're going to show success.

We're going to show some progress with these individuals, get them off the streets, have the get to stability and recovery, and then we can take it back to our funders and say, look at our numbers, look at our data, look at how much we've spent or haven't spent, you know, on the incarceration and the hospitalization.

And that way then hopefully we get, you know, additional funding where we can hire some more the case manager pieces where they can go out and we can add the number of clients.

Are you optimistic that this will work?

Yes.

Why?

Why?

Because we need it.

We need it to We have the collaboration here.

We have a good team in Scott County, and everybody is passionate about it.

Because you don't want to give up on these people.

No, no, this is where we live.

This is our community.

And it's easy to look the other way.

Yes.

You know and then walk past them and go, that's somebody else's problem.

But it is somebody's problem.

Yes.

And it really is society and the community's problem.

And by doing this Right.

Like you said, collaboration throughout the community but also not sweeping it under the rug.

Correct.

Right.

They're there every day.

They're on the streets.

They're sleeping in the parks.

They're, you know, needing help but they don't know how to ask for it.

Or they may not even acknowledge that they need help.

They don't understand tha they have a mental health issue that can be treated, you know, relatively easily.

And, you know, we need to better use, state dollars and taxpayer dollars on what we're doing with these folks.

We need to help them in a better way.

Well, and you said 15 people off the bat, how will you measure the success of this program?

Lets say, after the first year?

I'm going to be tracking, after the first year, I will reach out to our providers.

So the hospital, you know, Vera French, the police department, the county attorney's office, the sheriff medic and ask them, give them the 15 names and say, tell me how much money you've spent on those providing service.

And I can pretty much guarantee you that money will be significantly lower than what it would be if you take that 7.1 million and divide it by five for each year, it'll be significantly lower.

And another goal we have is to increase housing stability by 50%.

So at least half of these individuals will have housing after this first year.

We know some of them are going to struggl with even having an apartment.

But again, we work with medications.

We work with Vera French.

You know, maybe we slowly work, through some housing issue and we'll get them in a house.

They need to be in an apartment or some sort of building, you know, where they can sleep and be warm and safe.

Well, as a as a therapist, as a person who' going to be on the front line, how are you going to measure success?

Because I know that I know that dollars and cents are important, but that's not your primary goal.

Your primary goal.

Of course, I'm not trying to diminish what you said, but your primary goal will be the individual.

So how will you be able to measure success?

And some might not even see it, but just going to one appointment maybe.

And they haven't gone in years.

Or you know, just the first ste is going to be progress enough.

Yeah, it's baby steps with some of these folks getting them to the center.

Yeah.

Well, we'll talk to you again in the future, if that's all right.

Yeah.

We'd love to come back in a year and give some more data.

And measure how well it went.

Right, right.

Well, I appreciate your time, both of you.

Thank you.

Thank you.

Our thanks to Lori Elam, director of the Scott County Community Services and the lead monitor for the Assisted Outpatient Therapy Program Beth Stffers.

Welcome to September.

There are still plenty of warm weather events on the calendar for the weeks ahead.

With a look at what's going o here, here's Visit Quad Cities.

Check out the things to do this week in the Quad Cities.

Start your week off by embarking on an unforgettable evening aboard the Celebration Belle for Captain Dinner Cruise.

Then get ready to enjo some live music on the rooftop of the Up Sky bar.

There'll be appetizers, cocktails and of course, an amazing view.

Then you can listen to free music by the Blackstones on the riverfront.

Grab your lawn chai and enjoy Thursday night groove.

Next, Dogtoberfest is happening at Crow Creek Dog Park.

You can expect raffle baskets, auctions of beer and food.

Finally, CorgiFest is back!

Experience Corgi races, food trucks, vendors, activities, and October Fest games.

For more events like these, check out our Events Calendar at VisitQuadCities.com Musician Murray Lee is best known for his part in four bands that have hit the stages around the cities.

There's Rude Punch, Heads in Motion, Logan Springer in the Wonderfully Wild and Murray Lee in The Sons of Hades.

Well we invited him to take the stage at the Black Box Theater, in Moline that is, to perform one of his originals.

So here's Murray Lee with “Little Victories”.

[guitar strumming] I didn't get a job, nor have I won the lottery, but I just made a perfect cup of coffee.

Sometimes it's all about those little victories.

Oh yeah.

[guitar strumming] My bills are overdue My bank account is overdrawn but I think that I just met someone.

Sometimes it's all about little matters at a one.

Oh, yeah.

[guitar strumming] Yeah.

winning big sure would be nice.

But worrying about it will put you on thin ice.

At least I'm not six feet underground.

Sometimes it's all about not beating yourself down.

[guitar strumming] Now I've got pretty cushy job, and it pays like a low budget lottery.

But I still crave that perfect cup of coffee.

Yeah, I'm still all about those little victories.

Oh, it's still all about those little victories.

[guitar strumming ends] Murray Lee with “Little Victories”.

On the air, on the radio, on the web, on your mobile device and streaming on your computer, thanks for taking some time to join us as we talk about the issues on The Cities.

[lively music] [music ends]