Sgt. Fidel Mireles II, a 25-year veteran of the Kalamazoo Department of Public Safety, remembers well the moment in July when he saw the boy holding a knife in his outstretched hand.
“He was maybe 10, maybe 12 years old,” Mireles said. “The boy was holding a knife by the handle, dangling it, so I didn’t feel there was a threat to me. I started to ask him questions: ‘Where did you find that knife? What are you doing with it?’ He said he wanted to give it to me. When I asked if he wanted to hurt himself, he said he did.”
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After offering the boy a Sprite and a snack, the sergeant brought him to the new Behavioral Health Urgent Care and Access Center, operated by Integrated Services of Kalamazoo (ISK). With a call to the boy's parents, who quickly agreed that their son needed help, the boy was taken to the center and treated for suicidal ideation.
Both the new center and KDPS have the same goal: To assist those in the community having mental health crises. The center, which opened in July, is a new tool that allows the two agencies, as well as other local police departments, to work together more effectively to do just that.
The center, located at the intersection of North Westnedge Avenue and Kalamazoo Avenue at the west end of downtown Kalamazoo, is a 7,900-square-foot building with nine treatment rooms, offices, waiting rooms, a conference room, a reception area, a lobby and a security office. A primary goal in creating the center was to divert people having mental health problems from incarceration and from visiting emergency departments at area hospitals. Another goal was to offer same-day treatment for mental health and substance abuse disorders for anyone needing it.
In its first month, the Kalamazoo County Sheriff’s Department, the Kalamazoo Department of Public Safety, the Kalamazoo Township Police Department, and the Portage Police Department received 346 calls flagged as behavioral health issues.
“If you look at just the city of Kalamazoo Department of Public Safety alone, they had 10,695 calls for service, and 125 calls were coded as behavioral health calls,” said Lindsay O’Neil, ISK program manager.
According to Beth Ann Meints, administrator of clinical services at ISK, the center is "seeing the full gamut of individuals going through some kind of crisis."
"Whether they are simply seeking a counselor, they need medication or they are feeling suicidal, many are dealing with substance abuse issues,” she said. “They may be mild or moderate issues, while others come here after being discharged from a hospital.”
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The sign outside Integrated Services of Kalamazoo's new mental health urgent care center. Courtesy of ISKFunding for the $5 million center came from several sources, including local philanthropic organizations such as the Irving S. Gilmore Foundation and from money awarded to Kalamazoo County by the American Rescue Plan Act. The center is located near areas with a high concentration of individuals receiving behavioral health services, including those experiencing homelessness, and is an easily walkable distance from nearby shelters and other parts of the city’s downtown area.
The Behavioral Health Urgent Care and Access Center joins two other urgent-care mental health centers in western Michigan: Pine Rest Psychiatric Urgent Care, which opened in suburban Grand Rapids in 2019, and First Step Psychiatric Urgent Care Center, which opened in Battle Creek in 2021. The centers have reported growing numbers of people seeking help. The demand at the Kalamazoo center, for example, was such that just two weeks after opening, ISK modified the center's hours from 8 a.m.–8 p.m. weekdays to 24 hours a day, seven days a week.
“We are Kalamazoo’s first such access center, and we saw right away that we needed to expand our hours and began that July 24,” ISK CEO Jeff Patton said.
Preventing incarceration
The partnership between ISK and Kalamazoo County police departments comes at a time when there is a nationwide shortage of mental health clinicians and when the number of those reporting mental health problems continues to rise
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O’Neil said the idea for the Behavioral Health Urgent Care and Access Center came about sometime in 2014–15, when she was working at ISK as a jail clinician on call to help incarcerated individuals in need of mental health care, and “by 2020 the idea had come together to form this center.”
All too often, those suffering from mental health problems end up incarcerated rather than receiving the mental health care they need. That’s especially true of young people of color, according to the National Institutes of Health.
In 2022, the Michigan Association of Chiefs of Police reported that Michigan public safety officers were being "overwhelmed" by mental-health-related service calls. In Kalamazoo, many of these mental health calls "can be mediated by officers and mental health professionals who can co-respond to critical situations," according to a statement from KDPS.
KDPS established its Kalamazoo Protect and Connect (KPAC) Council to address this need, working with ISK to plan and design the Behavioral Health Urgent Care and Access Center.
Riding along with officers
A hallmark of the collaboration is that a full-time mental health clinician rides along with officers every day to check on anything the officer codes as a mental health issue — welfare calls, domestic violence, disturbed or abused kids, overdoses.
KDPS also employs a social services coordinator/victim advocate who can respond to scenes and provide follow-up referral services to those in need.
"We deal with a lot of trauma and depression — our most common calls,” said ISK's O'Neil.
According to O'Neil, the urgent care center works with law enforcement agencies in Kalamazoo, Portage and beyond.
“The value of this program is that we are sharing resources with others in the community. We are no longer working in silos," she said. "Meanwhile, ISK staff is building relationships with law enforcement, and that is bringing about an informal kind of education in both directions, educating us about what their days look like. We are learning.”
From a public safety standpoint, the center is having an impact. In a statement, KDPS said "partners like Integrated Services of Kalamazoo have helped us tremendously with mental health crises by conducting assessments and providing other mental health services."
"We find these partnerships to be beneficial to both officers and the community,” the statement said.
“Nine times out of 10, people are having the worst day of their lives when they come to us,” said O’Neil. “Other times it might be a case such as when a person (whom) the police contacted us to help needed a motorized wheelchair to get around. We were able to do that for him.”
A model for others
At the same time, she said, centers like the Behavioral Health Urgent Care and Access Center are pivotal to providing information to other communities looking to adopt similar models.
"Other counties in the state are now opening similar centers, sharing resources and protocols in their communities," said O'Neil.
But ISK's Patton notes that the Behavioral Health Urgent Care and Access Center is "not an end-all."
The center cannot provide medical care such as wound treatment, treat physical illnesses or prescribe medication. For medical health care, people are urged to call 911 or go to the nearest hospital emergency department.
Likewise, people can’t call an ambulance to get to the new urgent care center – state regulations say EMS agencies must transport patients to hospitals, according to ISK.
The inability to renew prescriptions also is a void. The Pine Rest Psychiatric Urgent Care in suburban Grand Rapids has said that particular service has been a Godsend for patients who are between doctors or new to the area and who are running out of the psychotropic drugs that are a key part of their treatment.
The urgent care center also can’t keep people overnight, an issue for those who are waiting for a psychiatric hospital bed or who need a few days of care and observation in a clinical setting.
However, the success the center has experienced has ISK looking to the future.
“We are now looking to build our next phase, a Crisis Stabilization Center, as a diversion program for psychiatric hospitals," Patton said. "While people have same-day access here, they are not able to stay, but this new center would allow stays up to 72 hours, until an individual is stabilized. We hope to have that available within a year.
“One in 25 adults in the United States suffers from serious mental health issues. This has been a community effort, and we couldn’t have done this without community-wide support.”
This article is part of
The Science and Art of Well-being: Innovations and best practices in mental health care, a solutions-focused reporting series of
Southwest Michigan Journalism Collaborative. The collaborative, a group of 12 regional organizations dedicated to strengthening local journalism and reporting on successful responses to social problems, launched its Mental Wellness Project in 2022 to cover mental health issues in southwest Michigan.