CLEVELAND — It carries a stigma with so much power, people often suffer in silence. Studies say mental illness affects one in five adults each year. Experts say talking to someone can literally mean the difference between life and death. However, we found a service that provides face-to-face assessments for people in crisis isn’t widely available in Ohio.
Time to get help
“You know, I wanted to jump off the balcony,” said Phillip Shorb.
The Canton man said he became so lonely and depressed earlier this year, he became tempted to leap off the concrete slab that extends from his third-floor apartment.
“To me, I thought, ‘What’s the use of living’?” he said.
The retired textile worker has struggled with depression since he was laid off in 2006, but this spring, he started experiencing suicidal thoughts.
“When you start hearing voices and they tell you to go out there and jump, you know it’s time to get help,” he said.
He was too ashamed to ask for help, so a friend called the suicide hotline at the Stark County Mental Health & Addiction Recovery board for him.
A call, he said, that saved his life.
‘Trapped in my thoughts’
Around the same time, Michael Stock was struggling just to get out of bed.
The Rocky River resident said he was sleeping up to 12 hours a night and not getting anything done during the day.
“It was not easy for me to focus,” he said. “[I was] trapped in my own thoughts. Isolated.”
Stock started experiencing suicidal thoughts at 13. He was eventually diagnosed with anxiety, depression, schizophrenia and Tourette’s syndrome.
“It’s an everyday battle,” he said. “A battle that seems like it’s forever.”
After two weeks passed without improvement this year, Stock called the suicide hotline.
“I knew I had to get the help. I knew it.”
If you or someone you love needs help call the National Suicide Prevention Hotline:
Or text the keyword 4HOPE to Ohio's Crisis Text line at 741 741.
Mobile Crisis Teams
Every county in Ohio has a suicide hotline to help residents experiencing a mental health crisis.
However, there is also a service that offers something more to people suffering from mental illness: a house call.
Known as a mobile crisis team, it simply means trained mental health workers make in-person visits to do face-to-face assessments with people who reach out to the suicide hotline.
“I think it's even more important, if not as important, as having the hotline,” said John Rudolph.
For 21 years, Rudolph has answered phones and volunteered to be part of the mobile crisis response team at Frontline Services, which administers those mental health services for the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County.
Rudolph says visiting a person’s home can be critical to assessing their mental health.
“Obviously, you pick up on the things over the phone, but to be able to look somebody in the eye and judge their non-verbals, which obviously, over time, you get good at doing, can give you a lot of information,” he said.
“They might call in and say, you know, ‘I’m doing okay, and I go to work’ and, you know, on some levels, it seems like they’re still functioning,” said Rudolph. “You go to their home. And it’s evident that it looks like a bomb went off. They’re not cleaning up after anything. They don’t bathe. They’re barely eating. There’s no food in the fridge. They have isolated from others.”
“You can only get that sense by being in that home,” he said. “You can’t appreciate what they’re dealing with, without going there.”
5 On Your Side survey
When 5 On Your Side investigators reached out to state mental health officials, we found Ohio doesn’t track which counties have mobile crisis response teams.
We decided to figure out who has access to the critical service.
For weeks, 5 On Your Side investigators surveyed mental health boards in 88 Ohio counties to find out if they have mobile crisis response teams.
We found less than half of the state’s counties have a team. Only 39 counties offer some form of mobile crisis response, that may or may not be a formal team. Of those counties, 24 offer the service around the clock. The rest have limited hours and urged people in crisis to call their 24/7-hour crisis hotlines when no one is available.
We also found differences in whether a trained crisis response worker would conduct a face-to-face assessment with both adults and children.
Six counties told us they only mobile crisis response for minors under age 18.
Four counties said they only offer the service for adults.
Several of the counties we spoke with also said that every crisis call was handled on a case-by-case basis, considering safety concerns.
They also could not guarantee they would always be able to send someone to the scene of an active mental health crisis due, in part, to staffing shortages.
Pain in Portage Co.
Portage County is among the many Ohio counties that do not offer residents mobile crisis team services.
“Right now, we’re not able to afford that,” said John Garrity, Executive Director, Portage County’s Mental Health and Recovery Board.
He pointed to something counties have complained about for years: how Ohio distributes your tax dollars to county mental health boards. For example, Garrity said Portage County has the 18th largest population in Ohio. However, he said Portage receives the fourth-lowest amount of state funding for mental health services.
The lack of funding has become an even bigger concern considering trends in Portage County.
Thirty-one people killed themselves in the county last year — a record high.
The next step
Even Lori Criss, the director of Ohio’s Department of Mental Health and Addiction Services, was unable to explain why her department distributes more Continuum of Care funds to some counties.
She said she requested the Ohio Auditor of State to review how the department distributes your tax dollars for mental health services.
In June, it released a report revealing there’s no rhyme or reason behind how Ohio funds counties and recommended the state start using a ‘data-driven’ approach.
Criss said she will meet with county boards to “seriously look” at the way counties receive state funding and does not plan to make significant changes immediately.
“It’s something we’re really interested in digging into over the next several months so we can figure out with the next step is,” she said.
Even if the funding structure changes, it will still be left up up to each individual county mental health board to determine if they want use state funds to pay for a mobile crisis response team.
“Ohio is a local rule state, you know that, and Gov. DeWine is a big supporter of local communities and we know that each community knows their constituents best,” said Criss. “Our commitment is to making sure that research-based practices are put in place, that there’s outcome measures and that we’re assuring quality for the services that are implemented and continuous improvement to make sure that we’re building what Ohioans really need across the state.”
“We need more availability for a person to have that in-person assessment,” said Scott Osiecki, Chief Executive Officer, Alcohol, Drug Addiction and Mental Health (ADAMHS) Board of Cuyahoga County.
During recent webinars and community meetings about the community’s mental health needs, Osiecki said residents voiced strong support for mobile crisis services for adults and children.
In addition, the number of suicides in Cuyahoga County has climbed over the last five years, In 2018, 211 people took their own lives, the highest number in three decades.
However, due to limited state funds for services, callers often experience long wait times.
“Sometimes it can be 24 hours, 36 hours before [a caller] would be able to have an in-person assessment,” he said.
Osiescki said it’s critical to increase funding, especially for mobile crisis services.
Rudolph said delays visiting callers at home because his absence would leave the suicide hotline short staffed.
“I mean, in 2019, there is no damn reason why we shouldn’t be able to go out and reach out to these people,” said Rudolph.
“I often say to myself, ‘What happens to them?' My guess is nothing,” Rudolph said.
He’s frustrated because receiving the service can mean everything.
‘Let’s stay alive’
After Michael called for help earlier this year, he spent six days in a crisis stabilization unit.
“The fact that you’re not alone. That they make you feel like you’re not alone. Because you’re not… is important,” said Stock.
A doctor there changed his medication. It immediately boosted his mood.
He described his life now as “fantastic.”
“I’d say I’m sort of on Cloud 9,” said Stock.
During Phillip’s face-to-face visit with a mobile crisis response team, the workers noticed the detailed sketches he keeps in a binder.
They offered to help sign him up and drive him to art classes.
“It meant somebody cares, really cares,” he said. “It kept me from going over the balcony."
Even today, their kindness during one visit helps him battle the dark thoughts that invade his mind on many days.
“The challenge is, ‘Let’s stay alive instead of killing ourselves,” he said. “We’re all in this world together. Why leave it?”