As demand rises, Milestone expands support for older adults with mental health needs

Editor’s Note: Aging Matters is a series that examines programs, issues, and solutions that impact today’s seniors. This series is sponsored by Milestone Senior Services.

A person struggling with mental illness can find it very difficult to get the help they need. Knowing how to start isn’t easy when you’re very stressed and often confused about many things.

Fortunately, help is available in the form of case managers, professionals who help ill people get treatment and daily necessities and live as safely and independently as possible.

Milestone Senior Services in Kalamazoo (918 Jasper St., Phone 269-382-0515) provides case management for Kalamazoo County residents age 55 and older. Currently, Milestone is serving about 240 cases, a sharp increase in recent years.

The aging of the Baby Boomer generation is contributing to growing demand for support services, according to Sara Crouch, Milestone’s clinical manager overseeing Behavioral Health Services. She says her agency and others are seeing significant increases among residents 55 and older seeking assistance.

“Our behavioral health professionals work with clients to ensure ongoing access to needed mental health and medical services, financial assistance, housing, employment, social services, and other community support,” Crouch says.

A person seeking assistance doesn’t have to have a severe, persistent illness such as schizophrenia, bipolar disorder, or personality disorder. Someone struggling with anxiety might qualify.

However, anybody joining Milestone’s program must be referred there by Integrated Services of Kalamazoo (ISK). ISK operates the Behavioral Health Urgent Care & Access Center, 440 W. Kalamazoo Ave. (phone 269-373-6000), which is open 24 hours every day for anybody concerned about their mental health or experiencing a crisis related to it.

People experiencing a mental health crisis or seeking additional support can begin at the Urgent Care & Access Center, where they receive an assessment and referrals to appropriate community services, Crouch explains. Depending on the person’s needs, those services could include case management through Milestone or another agency, or assistance from a community health worker.

Crouch continues, “We like to consider our case management as walking alongside our clients. We don’t tell them what to do, but we also don’t do it for them. We want them to be independent, feel confident in being independent. If they want to look for housing, we help look for housing, but we don’t go out and look for housing for them. We like to be available; we meet our clients as often as they need us, sometimes once a month, sometimes twice a week.”

For clients with Medicaid/Medicare, there is no cost. For people with private insurance or none, services are based on the ability to pay. ISK and Milestone work together to establish a means to pay. Crouch says the goal is to ensure people receive needed services without creating financial hardship.

“A lot of times, clients come in the door for their intake here, and they’re still in crisis. So we do what we can with them in the next week or two to get some of those crisis needs checked off quickly to help them feel more stabilized and more independent,” she says. “We don’t want people to be in case management forever. We like to graduate people; we like to see them living independently. Some people probably will need case management for a very long time, some people don’t. But we like people to be independent if they can be.”

Discussing financial assistance, Crouch says case managers help determine whether clients need someone to manage their money, assistance fighting eviction, or connections to agencies that can help keep them housed.

“When it comes to employment, we will help to find employment, but we also have a program called Action Employment Services that we can refer our clients to. Then they get an employment specialist and a benefits specialist who helps them, if they get Supplemental Security Income or Social Security Disability Insurance, know how much they can work and not lose that. It also helps them get ready to do resumes, interviews, clothing for interviews, and transportation to get around for filling out applications or doing interviews.”

Of the approximately 240 people currently using Milestone’s case management, Crouch estimates 40 percent are homeless.

“We have people living at the Mission, we have them at Oakland House. We have people that live in the tent communities around Kalamazoo. A lot of our clients live in a car.

“How safe can we make them, being homeless? Do they need warm blankets if it’s wintertime, or do they need lots of water if it’s summertime so they don’t get dehydrated? How can we even help them live safely if they are homeless until we can get adequate housing? And some people in our community, we’ve found out, they’ve lived homeless their whole life. They’re probably going to live that way for their whole life — how do we help them be safe in that?”

Crouch says staff also connect clients with food, shower facilities, laundry services, and other basic necessities. When a need is identified, she says, the agency works to find a service that can address it.

Milestone’s Behavioral Health Services also assists nursing facility residents who have a mental health diagnosis. A federal law requires an annual assessment of how those people are doing. Milestone provides the service in Kalamazoo County and in Berrien County through a partnership with Riverwood Center, a community behavioral health clinic in Benton Harbor.

“Anybody who is living in a nursing home has to have an assessment upon getting into the home if they have a severe, persistent mental illness,” Crouch says. “Then we see them yearly to do another assessment to make sure their needs are being met, and do they need any additional support? Or if they’re getting better medically, can their mental health and their medical needs be met in a community environment instead of at the nursing home?”

Twelve to 15 such assessments are done monthly. A case manager goes into a facility to make sure a resident is getting their medicines and the correct ones, and not having any adverse effects. The manager checks on whether the resident should be in activities and get out of their rooms, so that depression doesn’t worsen. The manager and facility staff determine what can be done to help the resident.

Crouch says the assessments also examine whether a resident’s medical and mental health needs could be met safely in the community. The goal, she says, is to ensure people with severe mental illness do not view nursing-home placement as their only option.