Often, people in mental health crisis who go to an ER don’t end up being admitted to the hospital. Instead, many are transferred to something called an adult crisis residential treatment center, a facility where they stay for up to 10 days, working with staff to stabilize their mental health.
But 10 days of this kind of treatment is often not enough to get a person back on their feet and ready to return to their everyday lives. After completing a stay in a crisis residential treatment center, many move to an intensive residential treatment services (IRTS) program, a place where they will continue to receive mental health treatment for up to 90 days.
While making a move from one facility to another might not seem like a big deal, for people in serious mental health crisis, the change can set back their recovery, said Gabe Becker-Finn, director of operations, crisis and intensive residential treatment services for People Incorporated, Minnesota’s largest nonprofit community-based mental health provider.
“It can be so traumatic when you are going through a mental health crisis to get settled in for 10 days and then have to pack up your belongings and go somewhere else, get a new room. A move like this can be stressful. And stress does make mental health symptoms worse,” Becker-Finn said.
In recent years, People Incorporated has been moving toward a “hybrid model” of care, where crisis residential treatment and intensive residential treatment are combined in the same building, making mental health crisis treatment as seamless as possible. In a hybrid facility, patients receive both levels of treatment without being uprooted mid-recovery, often residing in the same room while their treatment protocols shift from one level of care to the next.
In mid-October, People Incorporated will open their latest hybrid program in Minneapolis at 3633 Chicago Ave. The building, formerly a crisis residence operated by Hennepin Healthcare, was purchased by People Incorporated.
People Incorporated CFO Kellan Tittle said Hennepin Healthcare representatives contacted his nonprofit to gauge their interest in taking over the building. “When Hennepin Healthcare was looking to exit they came to us because of our reputation with urgent crisis facilities,” he said. “They wanted to partner with us because they knew how committed and good we are at offering this service. We both felt it was a win-win for us to be able to bring this option into the community.”
The transition to new ownership and a new model of care went smoothly, Becker-Finn said: People Incorporated has extensive experience in the hybrid model of mental health treatment. Since 2021, the nonprofit has opened three programs offering both crisis treatment and IRTS — in Chaska, Minneapolis and St. Paul. The Chicago Avenue program will be the nonprofit’s fourth hybrid program.
The new building, with its 13 beds, expands the number of mental health crisis beds available in the Twin Cities, with People Incorporated providing 118 of them, Tittle said.
Hybrid model benefits
For years, crisis residential treatment has been considered a next step from emergency services, a temporary place where people can step down from acute mental health crisis and achieve some level of stability before moving on to more intensive IRTS treatment.
In crisis care, Becker-Finn explained, “We get a lot of referrals from various ERs saying, ‘This person needs help in a place that is supervised, where we can connect them to services, get them to see their psychiatrist and their social worker, their case manager.’”
The idea is that mental health crisis care is temporary, a bridge to the next level of care, he said.
“I look at it like the ER department in the mental health world.” The average patient stay in a crisis residential treatment facility is relatively brief, Becker-Finn explained: “It is a shorter stay compared with an IRTS facility. We can turn around crisis referrals a lot faster. It is in the name crisis: The core concept behind this service is to get people connected to the mental health system.”
Patients stay in IRTS programs for a much longer period of time. Historically, Becker-Finn said, patients are transferred to an IRTS program from a crisis residential program or a hospital inpatient mental health unit: “The IRTS stay is an opportunity to get your feet under you again, for you to meet with a psychiatrist, to get your meds established.”
For years, crisis residential treatment and IRTS have been treated as separate entities offering distinct-but-supportive services. Before People Incorporated turned to a more hybrid approach, clients, reluctant to upset the apple cart, sometimes asked why they needed to physically transfer from one program to the other.
“People go into a crisis treatment program and oftentimes they are asking, ‘When I go into the IRTS stay, can I just stay in this program?’” Becker-Finn said. The nonprofit’s hybrid model was created in response to such requests: “I think it works really well as far as getting people who started in the program learning some new skills.”
People Incorporated isn’t the first mental health nonprofit in the nation to offer a hybrid approach to mental health residential care. It’s happening in other states, Becker-Finn said, but in Minnesota, People Incorporated’s size and reputation have helped to make the transition to this new model go smoothly.
“I wouldn’t say we pioneered this approach,” Becker-Finn said. “I would say we are the only one with this amount of flexibility to be able to provide both services in the same location.” That flexibility is a factor of his organization’s size and reach: “We are so much bigger than most mental health nonprofits. It’s great in that you can come in and we can get you connected to so many people in services based on what you need.”
Another benefit of the hybrid model of mental health residential treatment is its ability to support the strength of relationships established between clients and support staff, Becker-Finn said. Instead of having to forge new connections with social workers, therapists and psychiatrists in a new IRTS location, clients can instead continue existing partnerships throughout their full recovery.
“My staff really go to bat for people once they get in there,” Becker-Finn said. “They want to see the people succeed. Honestly, the biggest factor of success in all of this is the relationship between the person we serve and the provider.”
Committed to the community
By locating their latest hybrid program in the heart of Minneapolis near George Floyd Square, Tittle said that People Incorporated has confirmed its commitment to supporting the health of the city and the people who live there.
“It’s a great opportunity for us to expand our footprint in the community,” Tittle said. “We want to make this a place that feels welcoming and intentionally connected.”
The program’s central location is also a benefit for clients and health care providers, Becker-Finn added. “We have a lot of large hospital systems nearby. We take referrals from all of them.” This physical closeness means that clients who are treated in nearby ERs can get connected to residential crisis care within hours, rather than days. “We are able to get somebody a referral in the morning and then they are at our place in the afternoon.”
The Hennepin Healthcare building was already well suited for the kind of facility People Incorporated wanted to run, Becker-Finn said. It only needed a few alterations and touch of paint to get it ready for clients. “One neat thing about Chicago Avenue is they are all single rooms. You don’t have a roommate. That ability to be in your own private space and process things, have a bit of time to yourself, is really valuable.”
Tittle added that all changes in the building were designed to create a place for patients to focus on their recovery. “Inside the building we try to make it as client-centered and calm and healing as we can,” he said. “We selected calming paint colors, new beds and TVs. We are trying to make it as serene as possible. It also has a really nice backyard space, even though it is in the middle of the city.”