Nearly every chair in the gallery of Room 301 in the Civic Center Complex was filled, and an overflow crowd had gathered in the hall outside. The people assembled weren’t seeking a tax decrease or lobbying for better roads. Instead, when the Evansville City Council voted to approve a six-figure reallocation of city money to help fund mental health and substance abuse treatment facilities, the crowd cheered.
Long relegated to institutionalism and the criminal justice system, increasing mental health issues and drug epidemics have broken into the mainstream, affecting the general health and safety of the community at large. A crippling pandemic has only made things worse. Now, local government officials, health care providers, law enforcement, and community leaders are pooling their experience and dedicating their resources to collaborative efforts, tailored health programs, and — perhaps most importantly — treatment with dignity.
At the city council meeting on Feb. 28, these two important health issues —sometimes treated separately and different, despite often being entwined — were, as some said, finally receiving their day.
A Changing Mindset
Despite increasing awareness, substance abuse and mental health crises have for many years been widely regarded as afflictions on those of weak countenance or ill repute. The response from law enforcement and health care providers largely was the same: Lock them up and throw away the key. The opioid epidemic, with its indiscriminate nature and breathtakingly widespread devastation, began turning the tide.
Concerned by the revolving door of substance use disorders appearing in the court, and to help break the cyclical nature of drug and alcohol abuse, Vanderburgh Superior Court Judge Wayne Trockman in 2000 launched Vanderburgh County’s Treatment Court. Research and the increased number of offenders with substance use and mental health disorders proved to Trockman that prison does not, in itself, rehabilitate people struggling with these disorders, and a dedicated program could not only reduce recidivism but also intervene on a progressive and chronic illness. Trockman hired Lisa Seif, a licensed substance abuse counselor, to train and implement a more focused treatment program for the offenders in his court.
Before the treatment court, physicians, emergency rooms, and employers intervened but only for a short period of time. Seif says she and Trockman knew recovery was lifelong, not a sprint. Now, the criminal justice system and health care providers are collaborating on treatment plans based on a person’s affliction, culture, gender, age, and ability to make the needed changes. Through a treatment process based on incentives, those admitted to the program are assigned case managers and social workers; undergo a therapeutic, counseling, and coaching intervention; attend treatment for two years; and are heavily monitored.
“Creating the court and using the treatment team model with offenders has been revolutionary,” Seif says. “Before that, they were locked up when they were sentenced; that was the community model. Since 2000, the entire process and format for treating people with substance use disorder has changed dramatically. From health care to law enforcement to academic systems, there is a more collaborative and action-oriented mindset.”
Now, treatment programs prioritize preparing people for long-term treatment. Alcoholics Anonymous, Narcotics Anonymous, and other 12-step programs are there for a lifetime and have shown better success than others for the past 50 years.
“AA is at its essence a program of liberation, of freedom from self and fear. Part of the liberation is realizing that I’m not in control,” says Tom K., a retired Evansville physician who began drinking as a teenager and characterizes himself as, fromthe start, an alcoholic. “As a physician, it’s very easy for me to drift into egoism. AA is a hugely important part of my recovery. We have to go back and recharge our batteries with our fellow alcoholics.”
Even for those who do not suffer a drug or alcohol addiction, like Evansville native Jill Young, dedicated programming can help them turn a corner. Young was charged with a DUI in December 2020 after a celebratory drink with a friend led her to operate her vehicle while under the influence. She voluntarily entered a program requiring community service, breathalyzer testing six days a week, and no out-of-state travel unless approved by her probation officer. Throughout her 16-month sentence, Young shared her journey via social media to both peel back the curtain from the criminal justice system and hold herself accountable.
“I documented and made very public everything I was going through and feeling: the lows, the highs, probation. It showed a day in the life,” she says. “I did that to state that I’m just like any other person, and I messed up once, and now my whole life has a strike on it. I had to build my own confidence back up. This was a big hit on my part.”
As the opioid crisis forced minds to change about substance abuse, so has a better understanding of mental health. Indiana’s third certified Mental Health Court was launched in 2013 in Vanderburgh County to help residents whose mental health issues bring them into contact — sometimes repeatedly — with law enforcement officers.
“It fits really well into health care, that mental health needs to have a seat at the table. Psychological fitness patients are now getting attention,” Seif says. “We can’t ignore anymore that there is something personal and systematic about mental health and substance abuse.”
A changed mindset and response by law enforcement is the result of a concerted effort to bring crisis intervention to the forefront. A collaboration among city officials led to Officer Mario Reid, a former Department of Child Services caseworker now with the Evansville Police Department, taking on mental health-related incidents part-time.
“You have a case management approach you have to take for everything,” he says. “If law enforcement is involved, it’s already an emergency situation. If we see a problem, we figure out what resources are available to solve the problem and get those people to the table.”
Owing both to the demand for and importance of such collaboration — EPD had 254 mental health-related runs in March 2022 alone — Reid was named the department’s first full-time Community Mental Health Liaison Officer in February.
“When dealing with mental health and addiction, you have to hold everyoneaccountable, including the providers,” he says. “There has to be balance by building good relationships but also establishing boundaries and non-negotiables.”
Over the past two years, agencies ranging from Southwestern Behavioral Health and United Caring Services to Easterseals, the Vanderburgh County Health Department, and the new Indiana University School of Medicine – Evansville campus have met to identify gaps in local treatment programs. Flowing into the process is a portion of the $64.4 million from the federal government’s COVID-19-related American Rescue Plan, which Evansville Mayor Lloyd Winnecke has called “a chance to really make a difference.”
At February’s city council meeting, $300,000 was reallocated to help open United Caring Services’ six-bed Crisis Care Center, which will offer short-term treatment for people experiencing a mental health crisis or substance use issue, and renovate two Southwest Behavioral Health properties for short-term, post-hospitalization treatment for adults and neurodevelopmental psychiatry services for children and families.
The treatment court is also continuing to bolster its treatment programs by adding a component to involve participants’ families.
“Research and experience have shown us that long-term recovery demands that we continue adjusting our models to support recovery for a lifetime, and the best way to get that change for a lifetime is to have the family along,” Seif says. “We are not treating our patients fairly if we don’t start using a systems model that includes loved ones, families, and support people.”
Rashawn Williams, a Raleigh, North Carolina, native living in Evansville, knows the impact of a supportive network. When he began sobriety last year, Williams was supported by the Evansville Rescue Mission’s orientation programming, meetings, and sponsorships. Williams says he’s grateful for the programs in Evansville that have helped him become sober, and now he is offering that support to his loved ones back home.
“Some of them still do their thing. I tell them, whenever they’re ready to stop or they feel like they’re out of control, I’m there,” he says.
Phillip Boyd, a case manager at the Evansville Rescue Mission, and his wife, Micah, laud the strength and compassion of Evansville’s recovery community in supporting Tri-State residents who need help with diverse, inclusive programs.
“Evansville, for the size of our city, has an amazing recovery network. There are 200-300 meetings a week,” says Micah, a Newburgh, Indiana, native and herself a recovering alcoholic who now works with Vanderburgh County’s Drug and Alcohol Deferral Service. “We are a unique pocket of enthusiasm.”
Still, areas needing improvement exist. Boyd says same-day admittance into a local detox facility is frequently impossible because of a lack of beds.
Similarly, there is no regular, easily accessible transportation for those who need immediate treatment. Likewise, there exists a need for long-term mental health care, something the new facilities whose funds were approved at February’s city council meeting may not provide.
“All of these places are short-term acute care crisis stabilization. What are you going to do when they are released?” Boyd says. “We’re putting a Band-Aid on a bullet wound.”
Despite areas of improvement, many agree that positive change has come to Evansville, and they plan to use this momentum to propel the city’s efforts forward.
“Sometimes it feels like the wheels of change are slow,” Boyd says. “But taking a step back and looking at program changes and new services, we’ve accomplished a lot.”
Evansville Rescue Mission
Southwestern Behavioral Healthcare
Southwestern Indiana Alcoholics Anonymous
Vanderburgh County Drug and Alcohol Deferral Service
Vanderburgh County Mental Health Court
Next Level Recovery Indiana