According to the National Alliance on Mental Health of Ohio, 10,655 people in Ohio are homeless and 1 in 5 live with a serious mental illness. Many are undiagnosed and go without proper care due to poor access to mental health providers.
As a result, many people suffering from a mental illness turn to local emergency rooms for behavioral healthcare, treatment for other serious medical problems, or both.
The Visiting Nurse Association of Ohio is reaching out to these patients and meeting them wherever they call home. Marilyn Culley, a VNA psychiatric nurse practitioner, is one of the team members working to increase access to mental health services on Cleveland’s near west side. Through a grant from the Three Arches Foundation, she is helping bridge the gap in services for patients after discharge from the hospital.
She describes many of these patients as severely persistently mentally ill. Many have serious diagnoses such as schizophrenia, schizophrenia affective disorder, bipolar, general anxiety and major depressive disorder.
“Our goal is to help get folks into more permanent care,” she explained. “We facilitate that. Patients don’t know what to do and need help navigating the social services system.”
Culley explained that a VNA social worker also is available to link patients with other community services. Many need help with basic needs like food and shelter.
“This is mainly a transient population, and many do not have permanent homes,” she said. “We meet folks wherever they are at... we go to their home, or whatever they call their home, to help get them into a stable situation.
“We treat the patient holistically,” she continued. “We stabilize their symptoms and try to make sure their basic needs are met.”
Culley says one good outcome for these patients is getting into a group home, where they can get meals, wash clothes, and receive help with transportation.
“Then the patient is living in a community and their medications are monitored,” she explained.
As a nurse practitioner, Culley also writes prescriptions, which is crucial for those in need of interim medications. Long-acting injections are commonly prescribed so that the patient does not have to worry about missing a dose.
“We know the meds work – but people start feeling good and stop taking them. That’s why the long-acting injections are used,” she said. “In case they miss appointments due to many barriers, the injections help them stay stable – this is the number one goal – to keep them stable.”
Outside of Culley’s work through the Three Arches Foundation grant, VNA behavioral health nurses also see lots of patients who live in traditional homes and qualify for homecare. She explained that homecare provides the nurse with the best picture of a patient’s lifestyle and that this insight improves treatment.
"Nursing homecare is a good thing,” she added
VNA of Ohio is a pioneer in homecare. Founded in 1902, its team of nurses have a long history of supporting people where they are most comfortable: in their own homes. For more information about VNA homecare, call (216) 931-1300.
If you or someone you know are experiencing a mental health emergency, call or text the Suicide and Crisis Lifeline at 988, available 24/7, or go to the nearest emergency room.