LOWELL — In 2018, the Middlesex Restoration Center Commission started work around a compassionate premise, built on science-based practices, that people suffering from mental illness or substance abuse disorders needed a different approach to the incarceration and hospitalization model that had proved to be both costly and ineffective.
“The overarching goal — the No. 1 goal — is to treat mental illness and substance use disorder as the illness that it is,” state Sen. Cindy Friedman said by phone on Friday. She said that police officers and emergency room doctors are often the providers of “last resort” in trying to provide services for this at-risk population.
The center’s work for the past six years has been focused on taking that behavioral burden off of the law enforcement and judicial systems and out of emergency departments, to get people the care they need in the appropriate place.
On Tuesday, the state Executive Office of Health and Human Services and the commission announced that Vinfen, a Greater Lowell community behavioral health center, will deliver the wraparound clinician-based services for people with complex mental health and substance use disorder issues in Middlesex County.
It’s a vision that commission Co-Chair and Middlesex Sheriff Peter Koutoujian has long recognized as a desperately needed and underserved space in the policing community. He sees the impacts of both mental health and substance use disorder in the Billerica House of Correction, where 57% of the inmate population have a diagnosed mental health disorder, and 80% with mental health issues also have substance use disorder issues.
“The crossover in these populations is incredible,” he said, on the call with Friedman. “We have 1,000 behavioral health contacts each month in the jail.”
The commission, Koutoujian said, was focused on improving health outcomes for that population, to enhance public safety and save taxpayer dollars. Region 3, an EOHHS zone of 50 communities, including Lowell, had one of the highest emergency department boarding rates in the state.
Boarding refers to the practice of holding patients in emergency departments or hospital hallways, while waiting for a bed to open up, tying up both emergency department beds and police officers in the process.
“The Restoration Center can be available for [emergency department] diversion,” Koutoujian said. “It can be in place for law enforcement drop-offs. Instead of making an arrest and involving the justice systems, which is the only tool in the tool belt that many of these officers have, you can divert them to the services they need.”
A standalone Restoration Center facility is still in an investigative stage. In the meantime, Vinfen will provide beds through its behavioral health center model of programs and services.
“We’ll consider whatever works,” Friedman said. “This is a pilot, proof-of-concept based on much proof out there that these kinds of things work.”
Established in 1977, Vinfen is one of the largest community mental health and disability providers in the commonwealth. Among its many services, it helps to stabilize people who are having a psychiatric crisis.
In January 2023, the outgoing Baker-Polito administration opened 26 new community behavioral health centers as part of its Roadmap for Behavioral Health Reform plan, a statewide initiative for managing the behavioral health crisis in the commonwealth. Vinfen is part of that behavioral health network, with facilities serving the Lowell community.
The community centers are designed to help residents access behavioral health services, reduce reliance on emergency rooms for mental health support, and increase the availability of these services in the community.
Commission Co-Chair Danna Mauch, who is president and CEO of the Massachusetts Association for Mental Health, said the commission was successful in bringing the pilot to fruition due the high-level support across governmental agencies at the state level.
“I attribute (the commission’s) success to leadership,” she said by phone Friday morning. “There was an unprecedented level and consistency of participation. I attribute it to the leadership and clout of Senator Friedman and Sheriff Koutoujian.”
She also noted that the commission’s work began under former Secretary of Health and Human Services Mary Lou Sudders in Gov. Charlie Baker’s administration, and continues under Secretary Kate Walsh in Gov. Maura Healey’s cabinet.
Besides political and professional expertise, the commission’s work benefited from high-level funding streams, too.
The body secured almost $10 million to advance its Restoration Center work, including $3 million from Friedman’s legislation, $5 million in American Rescue Plan Act monies and $1.65 million from U.S. Rep. Lori Trahan in congressional spending.
That fundraising work continues, said Koutoujian, so that the commission can tailor the model to meet the needs of Massachusetts residents.
“We are still in the process of chasing down private and grant money, too,” he said. “We need multiple funding streams … we’re shaking the trees.”
Friedman agreed, especially if the pilot meets the commission’s expectations of diverting individuals away from criminal justice involvement and emergency departments and into treatment.
“The next steps are very financially intensive,” Friedman said. “We have to find a spot. We have to staff it. How does that work? That’s a huge investment in all of this. Probably the most important investment.”
Mauch said it was privilege to be part of the center’s work on a personal and professional level.
“I have a deep personal commitment to individuals with these kinds of needs,” she said. “My organization has been around since 1913 trying to advance the understanding of mental health and substance use disorders. People can be treated and can recover. This work brings alive that vision and mission.”
