Day care centers for the mentally ill like a version of the Cheers cafe They know when you have a day off

Marissa Wegner, left, listens as Martha Bird gives her tips on weaving her own basket during a class at Vail Place, a non-profit provider that offers daytime activities and facility for people with mental health issues, at their Minneapolis headquarters on Thursday , July 6, 2023. Working on the baskets helps my mind focus, Wegner said. (John Autey/Pioneer Press)

When her mother and stepfather moved out of state, Marissa Wegner found herself visiting youth centers in St. Paul, Minneapolis and Bloomington to while away her days. Wegner, who grew up in Rosemount and lives in public housing in the St. Paul’s Cathedral Hill neighborhood, dropped out of youth programs when she turned 25, leaving her with few social outlets.

Then came the pandemic, which further isolated it, an especially scary place for someone grappling with lifelong mental illness.

I went crazy during COVID, said Wegner, 28, who said she lives on the autism spectrum and suffers from depression, anxiety and attention deficit disorder.

She found the community she was looking for at Vail Place, a non-profit service provider that operates Clubhouse-themed day care centers that offer adults with mental illness structured

activities in the Minneapolis Uptown and Hopkins neighborhood. She kept busy discussing pets on the Vail Place Podcast, and on Thursday she spent an early afternoon weaving decorative baskets with fellow Clubhouse member Martha Bird, a registered nurse who discovered Vail Place after a back injury took left Bird spiraling into depression.

It’s like a second home, said Wegner, who appeared in a Clubhouse musical production last year at a dance hall fundraiser in Golden Valley, fulfilling her lifelong dream of taking the stage.

Margaret Humphrey, a former senior planning analyst at Hennepin County Human Services, recalled the mental breakdown that led to 11 weeks of partial hospitalization and outpatient care at Hennepin County Medical Center. A group counselor, Chad Bolstrom, suggested she turn to Vail Place for social support. That was 10 years ago and she has been a regular member ever since. Bolstrom is now the director of the nonprofit program.

At Vail Place, you matter here. It’s kind of like the mental illness version of the Cheers bar they know when you have a day off, Humphrey said. I can come here and say I’m switching medications and everyone will moan together, because they know how hard it can be.

When you get out of all these inpatient programs, you go from having all this attention and support and kindness and compassion and then there’s just nothing, added Humphrey, who lives in the Hamline-Midway neighborhood of St. Paul. Everything is centered on the crisis of the last five years. We don’t have anything (in Metro East) just focused on keeping people settled in the community.

Looking for expansion and new funding

Karina Forrest Perkins hopes things can change soon.

Perkins, who was named executive director of Vail Place last October, is pitching the Clubhouse model to Ramsey County, Greater Minnesota officials and state leaders in hopes of opening more day care centers across the state.

It’s not about drugs or a therapy visit, he said, noting that as many as 40 percent of members have some form of employment. It’s what you need every other day of your life when you’re not in a crisis. (But) there is no fee structure to support that.

Last year, Hennepin County cut its long-standing block state funding for Vail Place in half, reducing it by nearly $1 million over a two-year funding cycle, to free up state-backed dollars for initiatives. of adult mental health (AMHI) for more culturally specific treatment programs. This left the nonprofit scrambling to fill budget holes as it looked to expand.

There have been other challenges. During the early days of the pandemic, some services went hybrid or online entirely via Zoom, which has been a mixed blessing. The pandemic has done a number on us, Bolstrom said. Mental illness is often by its nature an estrangement from people and support structures.

Discussions with Ramsey County over the past six months have focused on the possibility of funding a Clubhouse location somewhere in Metro East. At the same time, Perkins said Vail Place has been engaging state lawmakers in potential funding strategies that could support similar sites across Minnesota. About 28 states help support clubhouse-style centers for the mentally ill, with most using state-administered Medicaid reimbursement to cover costs. At their Uptown and Hopkins locations, Vail Place doesn’t charge members a fee, and made-from-scratch lunches are also $2.

There’s an active coalition in Ramsey County that has wanted this for years, and we’re now in a very intentional strategic partnership to achieve that goal for them, Perkins said. From a mental health perspective, our state is in crisis. We are not reducing the demand for mental health. Conversely, more people need mental health supports and fewer people receive it.

Alongside former State Representative Andy Dawkins of St. Paul, former State Representative Mindy Greiling of Roseville serves as co-chair of a Vail Place Expansion Effort Committee for the Ramsey County affiliate chapter of the National Alliance on Mental Illness, or NAMI. Greiling, who has written a book about raising a child with schizophrenia, said she was impressed by the nonprofit’s upbeat environment, a far cry from the gloomy halls of many psychiatric wards and its transitional work placement program, which he placed workers at Kowalskis Markets and the Sea Salt Eatery in Minneapolis.

Greiling noted that the first Clubhouse was started in New York City in 1948 and now certified Clubhouses can be found in most US states and 30 countries. While membership is free, it comes with more responsibilities members agree to stay engaged in 9am-3pm activities and opportunities than a typical drop-in center.

It’s a completely different model and it’s evidence-based, he said.

A future in Ramsey County?

Bolstrom said all seven members of the Ramsey County Board of Commissioners conducted site visits at locations in Uptown or Hopkins, centers that could be mistaken from the outside for residential homes.

Ramsey County Board Chair Trista MatasCastillo said that while several county commissioners have expressed interest, the board as a whole has yet to host a formal discussion.

A likely next step would be to partner with a local chapter of NAMI to form a working group. The key questions would be the level of partnership provided by the county and whether the relationship would fall within the county’s social services, workforce or another department. No funding decisions are likely this year, she said.

I think there are many things to explore in this landscape, but we recognize that there is a gap and a need, MatasCastillo said on Friday.

To expand the Clubhouse model statewide, Medicaid reimbursement authorization would require state action, including determining whether Medicaid will cover Clubhouse services by the hour through a per-service fee model or through some form of subscription package . And within both options, those repayments could be structured in different ways, Perkins said. Discussions are ongoing with the state Medicaid office.

The whole spectrum, how we should be painted

Mark Jensen said he spent six weeks in an induced coma in 2009 while suffering from pneumonia, and came out confused and depressed. Antipsychotic drug packed on weight.

Up until eight years ago, I was basically getting through the day drunk, hating everything, he said.

That’s when he discovered Vail Place, where he immersed himself in myriad tasks, from podcasting to serving on the nonprofit’s advisory board. Jensen said he’s lost 150 pounds in just the past two years and recently moved into a new apartment. He also gave up drinking and formed close ties with staff members.

Staff time is really important to us, Jensen said. We don’t need the level of care you would get in a hospital, but we do need more than (the typical person) living alone.

For the past nine years, a group of writers associated with the History Theater in downtown St. Paul has put on an annual Vail Member History Show. After May’s performance, which he helped tape, Jensen said he walked away in humiliation.

This was my first History Theater performance to experience, and it was in many ways a different performance than I expected, Jensen said, in an email Friday. Some stories I experienced firsthand too, but some told the past of my fellow Vailers that I didn’t know, and now I look at them as people who are stronger, funnier, more real than I allowed them to be in my mind. I fell with my illness after coma and I, having only lived this life since 2009, can sometimes paint us all with a single dark acrylic instead of the full spectrum as we should be painted.

Grace Rinehart, an occupational therapy PhD student at the University of Minnesota, spent much of late June and July shadowing workers at Vail Place, and was impressed by the attitude of going at her own pace in helping members to apply for social services, conduct job searches, and perform other duties.

It helps find that balance, when to step in to help and when to actively listen, Rinehart said. Clubhouses like these need to be better advertised.