(upbeat music) (upbeat music continues) - Welcome to "At Issue."

I'm H. Wayne Wilson.

Thank you, as always, for joining us, this time for a discussion about mental health.

It's an issue we've addressed before on this program.

It continues to be an issue.

There are certain things we need to address, the workforce shortages, the effect of COVID-19 and other things.

And we're going to do that with a panel of three experts, including Dean Steiner.

Dean is the Executive Director at Unity Place.

Thank you, Dean, for joining us.

- Thanks for asking us.

- [Wayne] Mary Sparks Thompson is here.

She is the President of Unity Place.

Thank you for joining us.

- Well, I'm happy to be here, thank you.

- [Wayne] And welcome to Peoria.

You've been here about a year.

- That's right.

Thank you.

- And also joining us, Caitlin Scott.

Caitlin is a clinical director, or the Clinical Director at FamilyCore.

Thank you for rejoining us on "At Issue," This side of the table - Thank you.

- is veterans to "At Issue."

So Mary probably should start with a definition of Unity Place, just so we get that out for the audience.

What is Unity Place?

- Yeah, thank you for the question.

So Unity Place is a unique organization in that it brings together two community mental health centers.

They have been historically known as Human Service Center and Tazwood Community Mental Health Center to join with Methodist Hospital so that we have a full continuum of care.

So we have inpatient services, we have residential services, and we have community based services, outpatient mental health.

So really soup to nuts type of service.

I describe it as four levels of care, 39 programs, and over 600 staff providing that care.

- And we probably should say something about FamilyCore so we understand its role in the community.

- Sure.

So FamilyCore is a nonprofit social service agency.

So we have kind of three main pillars that we're working with.

So we have our Foster Care Department that focuses heavily on those families involved with child welfare, so supporting the children and the parents and the foster parents.

We have an Outreach Department and within that program, we have a lot of workers that are in the schools.

So we have 22 schools that we're working with, providing social and emotional support to students.

We have adoption preservation work and a respite program.

And then we have our counseling program.

And within that, we have our outpatient therapists and we have a single parent program that's case management services.

- And before we get into the weeds of the conversation, Dean, can we, without going through a litany of numbers, describe the need and how serious the mental health problem is in Central Illinois?

- I think one of the things that we've seen, maybe especially since the pandemic is an increase in that, in the need for mental health services.

There's always been a strong need here.

And I think a community that comes together to work on mental health issues, that continues.

I think that community has grown stronger over the past several years, especially.

But the need, I think sometimes we feel overwhelmed with that just because of the demand and really being able to meet that need.

Inpatient, outpatient, all levels of care, as Mary pointed out, all the different levels of care, I think there's a demand, high demand for all of it.

- At the same time, we all know that there's been a workforce shortage, not just in Central Illinois, this is probably nationwide.

How are we addressing that?

- That's a very significant issue.

And one of the things I speak about when I talk about workforce, is it's really affected all sectors of the economy and it's hit healthcare hard.

We have healthcare workers who've been at the front lines for quite some time.

There's some fatigue.

Interestingly, we've had a little bit of an easing in the openings that we've had.

So we're seeing some increased interest in people returning to the workforce.

However, it's probably the biggest limiting factor we have in terms of expanding and growing our programs.

We've had some generosity here at the local community level in terms of providing us funding to allow us to recruit psychiatrists to stay here, as well as increasing our compensation so we can attract and retain talent.

So there's a lot of community interest in this area and we're working really closely to enhance our workforce through those means, and then also collaborating with local institutions around recruitment of those healthcare professionals.

- So you're working with University of Illinois, College of Medicine Peoria?

- Correct, correct.

- Do we see progress in terms of getting more psychiatrists to arrive, stay in Peoria?

- The trends that we're seeing here locally through the College of Medicine here are an increased interest in psychiatry residency programs.

So we have more applicants to our program.

We are really excited to be able to share the news that three residents that are in either year four and one in year three are going to remain locally in the area.

So we're seeing the tide start to turn in terms of us being able to attract and recruit that top talent to keep them here in Central Illinois.

- Let's talk a little bit, Dean, about the types of mental health issues that are prevalent here in Central Illinois.

Which ones do we deal with most often?

- I think probably the most frequent that we see are anxiety and depression.

We've probably seen a little bit of an increase in that since the pandemic for different reasons.

But a lot of people on different levels for their state of anxiety, the level of depression.

It's not just those two, however, it's kind of across the board, I think.

- Yeah, and I think I could add that we see a lot of grief and adjustment issues.

So how people are dealing with managing change in various ways, which could materialize as depression or anxiety.

But the transitions, I think, in general, have been increasing and harder for people.

- So is there a way to define, Dean, define depression or anxiety?

Because I may get up one morning and say, "You know, I've got so much on my plate, I don't know how I'm gonna handle this."

Am I depressed?

Am I anxious?

Or where's the line that you cross over?

- I think you asked a good question there.

I think one of the things that we have to keep in mind is that we all experience some level of anxiety.

Anxiety can be motivating.

If I didn't have some kind of anxiety, where's my drive to meet deadlines, or to meet certain expectations?

So there's a normalcy of that anxiety, and it may ebb and flow.

Same thing for depression.

We don't all have, every day, a peak experience where we feel on top of the world and life is grand and everything's great.

So I think we look at when it becomes impairing, when it hurts, when it may impact our relationships, when it may impact our performance at work, or for adolescents, kids, their performance at school.

That's the time when there's probably a red flag in saying, this isn't quite the quality of life, or not quite the experience that I want.

- So Mary, when a person says this anxiety, this depression, I'm recognizing I'm not functioning the way I should be functioning, I'm going to guess it's probably an embarrassment to some people to say, "I need to call for help.

I need to talk to somebody."

What do you say to a person like that?

Or what should a family member say to a person like that?

- That's such a great question.

And I think actually as I reflect on my career, I think the biggest change that I've seen is a reduced stigma in talking about any mental health issue.

I see this more in our youth and our young adults.

Many are willing to say, "Hey, I go see a therapist," or, "I have medication to help me manage my anxiety."

So I think I see a change in that, but we're not there yet, and that's always gonna be a work in progress.

So I would say to a person who's questioning whether they need to get help, that they probably would benefit from some help if they're thinking that.

I would say there's so many caring people out there that are ready to help.

So a lot of people start with their physician.

They may ask friends or colleagues who a good therapist is.

And then if someone needs medication to help manage symptoms, then they can be referred to a psychiatrist or even have that help from their family physician.

- One of the things that I've said over the years is that we could all probably benefit at some point in our lives, - Absolutely.

- the benefit of talking to somebody else, a trained professional, whether it's our physician, a counselor, whomever, to be able to kind of work through and talk through and sort through.

That's what we do from a clinical standpoint, is we help people kind of work through some of those issues.

- But you may even turn to your best friend or to your spouse or to your uncle and, "It's not a good day and yesterday wasn't a good day.

How about it, uncle?

What do you think?"

And is that okay to to turn to a friend, a family member?

- Well, I think, yes, but it might not be the only stop you make.

- [Wayne] Oh, no, no, I'm not suggesting that.

- Yeah, sure.

I think we turn to the people that we feel closest to first.

We usually find those to be most comforting, most supporting.

But there are limitations to that.

And I think the big thing about therapy or counseling is that it's a person outside the situation.

So your uncle or your cousin, they've experienced potentially, this situation in a much different way.

And so sometimes it's good to have that outside person to kind of hear you through, talk it out with you and process in a little bit of a different way.

So I think there's pros and cons to each of those scenarios.

- You have counseled both adolescents and adults.

- [Caitlin] Sure.

- Is there a difference in how you approach counseling for young people versus adults?

Other than the fact, the age difference.

- Sure.

I think honestly, I don't think there's a one size fit all for anyone that we see.

So each person that I see, I might approach things a little bit differently.

I think we know that kids, they may be expressing their feelings a lot differently.

So there's a lot of watching and listening for cues of what they're experiencing.

And adults may be more apt to say, "This is what's going on with me."

And a kid may say, "Man, I'm having such a hard time at school," and that's an opening for something to talk through.

So I think for each person that comes in, it's really listening and hearing and being aware of their needs to be able to support where they're at with things.

- When you get into counseling with a young person, Mary, they don't have the same, especially if they're 14 and younger, they haven't developed the same life connections, the same thought processes as an adult.

How do you deal with those young ones?

And I know that's, once again, it's individual in nature.

- There's different ways to kind of approach emotional issues with children.

Sometimes you can approach that through play, you can approach that through, always with children, it's important to get what we would call corroborating information.

So those who are in their daily life to report back on what their symptoms are.

So there's several different ways you can approach a child using their language, giving them time and space to trust you as an adult.

Typically, children are used to adults as perhaps being authority figures and may see the therapist in that light.

So giving them time and space to develop that therapeutic rapport so that they can begin to really explore their issues.

- And Dean, it may be a case of the adult has seen if there was an event in someone's life, an adult has seen this event before, a child may not have seen this event before.

- Correct.

And a child doesn't have the same coping skills that an adult has, hasn't been able to have the experiences and those life experiences that build those coping mechanisms and how to address it.

The other thing is, is that we've kind of talked about that, but it's maybe easier for an adult to say, "I'm depressed," because they can identify it.

Children, adolescents don't know.

They can't say, they may be able to say, "I'm depressed," but they may experience it in a different way.

And it may come out in ways that they don't know what's going on, just like Mary said.

- We know that when we have the flu, we recover from the flu.

And there may be some instances when you recover from a mental health, but is that a bad term to use?

- I don't think it's a bad term to use, but I think it's important that we realize that these things may kind of come and go in different ways.

And I think when I think about it, it's how much is it impairing your functioning today?

So on one day it might be, "Wow, this is like an eight out of 10 for me.

I'm having such a hard time."

And that may last for a little while and you work through it and you may get it to, "You know what?

I can sustain at a three for a little while."

And so we can see it kind of come and go.

I think we always hope for healing of some sort.

And we hope for a healing that's long lasted and it stays with you and this doesn't come back.

But our goal is always to improve the symptoms.

How do we decrease that for you so that you can engage in your life in a better way than you were before?

- Dean, you nodded your head.

- [Dean] Well, it's about the quality of life.

- Yeah, absolutely.

- And really what we're looking at is how do we help improve the quality of anyone's life regardless of what's going on with them?

- Mary, we know that sometimes it's just counseling that's needed, but other times, medicine has to be added to that equation.

And I think that people worry that, "Oh, gee whiz, the doctor, the psychiatrist is going to say, 'You're gonna be on medicine for the rest of your life'" or whatever.

How do we address this, medically speaking?

- I think that's a reasonable concern for people to not look to medication too quickly.

But I've also seen it be a very important tool in a toolkit.

So in your toolkit, you don't want just a hammer, you might want a screwdriver, or you might want a drill.

I don't know what, I'm not good at toolkits.

But anyway, it's a good analogy.

Medication would be one toolkit.

And a lot of times with careful monitoring and support, along with therapy, just your own natural coping skills, you can reduce your dependency or eliminate that dependency on medication.

Many people will take a medication for a short time in life to get them back to a place where therapy or other supports are as effective.

Over time, statistics and research has shown that therapy and medication, a combination are the best approach for managing mental illness of any kind, or depression, anxiety, anything in that vein.

- To my mind, it may be similar in that we were talking about how medicine is just part of, with counseling.

So perhaps inpatient and outpatient, Dean, may also be a combination in certain cases.

- Absolutely.

I mean, inpatient is just part of the continuum of services that we offer in the community.

And I think inpatient is really meant to be a short period of stay.

And it's really for someone who is significantly impaired, really just can't function, or really is struggling with that functioning, or may feel unsafe.

And so if that's the case, we wanna make sure that they're safe, we wanna get them back on track.

Not unlike what Mary was saying for medicine, it's really, that may be just brief and we get you back to a point where you can go back to outpatient work, whatever that may be.

Sometimes it may just be an adjustment of medication in a safe environment.

- But, Caitlin, when we talk about inpatient, that's where people say, "I don't need inpatient care."

How do we know when someone should go into inpatient and what's the cooperation level needed from the client?

- Sure.

I think when I'm working with people, we're constantly collaboratively assessing level of care.

So I think it's important for people to be able to understand and recognize their own impairment and how it's impacting their safety, their relationships.

And to really start to think about, "Do I need a higher level of care where I have greater access to services 24 hours, where I have access to medication management that can help me adjust that?"

So it's really kind of working together to assess, "How do I get myself to the next step?"

And it may be that inpatient part.

My goal is always that my client's able to make that decision for themselves to see, "This is what I need and I know that this is something I need," but that isn't always the case.

And so it's helping them to understand the next steps in the process.

It's connecting them with people that can help explain the process a little differently to work through getting them to where they need to be.

- So we've talked inpatient, outpatient, we've talked medicine, we've talked counseling.

What's the role of telehealth?

- Telehealth really gained a lot of momentum during the COVID-19 pandemic and it was a really wonderful option for treatment.

What we were able to do in outpatient settings in particular was really offer services when people could not get out of their homes.

So we kind of forget, yes, we were on lockdown, people were not leaving their homes to receive care.

So it was a really nice bridge to care for folks.

And we've used telehealth, we continue to use telehealth as a way to support our services.

So for example, if there's a bad weather event, we can, rather than close a clinic, we can offer telehealth appointments, as an example.

We have used some telehealth providers to help support care in all of our settings, our inpatient settings, our community settings, and our outpatient settings.

- This would not be a replacement in totality.

- No.

And I think there's a role for telehealth, but I still think there's a lot of value for that in-person contact and that relationship that can really flourish with that in-person care.

- We can probably say that about Zoom meetings and people who are on their phone all the time, et cetera.

That face-to-face really helps.

What about, Mary, let's go back to family again and continue the conversation about the role of a family/friend.

How important is it to have a support mechanism outside of your counselor?

- We know, most of us, through our own personal experience, and then also just knowing what's working in the literature that intimate or close friendships and relationships outside of your family bring a lot of richness to life.

There's nothing like talking to a close friend who knows you really well to support you through a tough time.

So I think those relationships, and I think that's something the pandemic taught us.

When we weren't able to have those normal get togethers that we had with friends, for example, there was a lot of recognition, I think at that time, of the value of those types of friendships and relationships.

- I think we became more aware of how important those were because we maybe took those kinds of relationships for granted.

And I think they've become more valuable to us as a society.

- We even see that in the workplace.

- [Dean] Absolutely.

- We recently just reestablished some of our regular meetings amongst us, leadership team in a face-to-face environment.

And the impact was pretty dramatic and pretty immediate.

The relationships that you form when you're in a shared space, exchanging ideas in real time, there's something about it that you cannot completely emulate in an electronic format.

- In a couple of minutes, we're going to give you two phone numbers so that you can access both Unity Place and FamilyCore.

So grab a pencil and paper, in a couple of minutes we'll give you those phone numbers.

I wanna talk about episodic, Dean, episodic mental health issues.

It's not necessarily, can I use the word, permanent?

- [Caitlin] Yes.

- It's not permanent.

It could be episodic in nature?

- Absolutely.

I mean, if you think about how life is, we have our ups and downs throughout life, and so the same thing with mental health issues in regards to, if I've experienced something traumatic, something that changes things for me, I'm gonna need some help.

That may be in downtime for me or a time when I really need that help that can resolve itself after some therapy and maybe some medication or whatever the course of treatment is.

Or I may struggle periodically with some depression.

Or again, we go back to kind of that level of functioning.

And if it's becoming so much at an issue for me, I need to get that help.

And maybe I got it 10 years ago and now I'm doing a different phase in life.

- But it's so difficult to know that I'm anxious because my plate is so full, how am I gonna get all this accomplished?

And then say, we talked about this earlier, but then, "No, no, I'm okay.

I'm okay, I'm just anxious as opposed to suffering from anxiety."

And how do you, I can't function anymore.

- It's how limiting is it and how much is it impacting your life?

You know, we have things on our plate.

A lot of people will say they have too much on their plate.

How are you managing that?

And if it becomes so debilitating.

Or maybe it's a matter of you talk to somebody for a few sessions, or you talk through, if you're not able to do that with friends and family, then you seek somebody out to kind of help you with that.

Again, it's just, I may need, if I'm really depressed or really anxious, I may need some medication.

I may not.

And it just depends on that level of impairment and how much it's impacting you.

- But might people self-medicate in hopes that I can solve this problem?

- Definitely, some people will self-medicate.

So sometimes we convince ourselves that we're just fine when maybe we're not.

And so one of the things that we were talking about earlier is knowing those signs and symptoms and the things that can really add to your own awareness of when to seek help and when to really take care of yourself.

- I'm going to provide those two phone numbers for you right now.

For the Unity Place, it's 888-311-0321.

Repeating, that's 888-311-0321.

For FamilyCore, the number is 309-676-2400.

309-676-2400.

I wanna finish the conversation, Mary, with something positive.

What can we say that is positive about we're turning a corner, we're providing more staff, whatever the case may be?

What bright star is on the horizon for mental health treatment?

- Well, I think of a couple of different things.

One thing I would want everyone in the audience to hear is that you should feel hopeful.

If you're struggling with a mental health issue, there's great treatment.

We have wonderful providers and wonderful care in this community.

And it's a community that's very supportive of mental health issues.

So I feel hope is really important for everyone to know that if you're struggling right now or have struggled in the past, it doesn't mean that you can't get better or that you will stay in the place that you're currently in.

And I also think we're starting to see a turn in terms of bringing people back into the workforce to provide that care for people.

So those would be the two things, hope and that I think we're starting to turn the corner on getting people to provide the care.

- And with that, a bright point, as we conclude the half hour discussion here on "At Issue," let me say thank you to Caitlin Scott, who is the Clinical Director at FamilyCore, - Thank you.

- Dean Steiner, Executive Director at Unity Place, and to Mary Sparks Thompson, who is the President of Unity Place.

Thank you all three for the conversation.

We hope you continue the conversation at home, as we will here in the studio.

And please join us next time for another edition of "At Issue."

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