BROOKINGS – Brookings Behavioral Health and Wellness is seeing an increasing demand for its services in the community, and that means the staff needs more room to do their jobs and help clients, said director Mary Beth Fishback.

“We have seen a pretty steady growth in the number of clients that we serve year over year,” Fishback said. “Part of our core service is to provide Brookings County with 24/7/365 crisis services, mental health and substance use crisis services.”

They counsel on a wide range of mental health and substance use issues for children and adults – and calls for service have been rising significantly in recent years, she said.

It’s important to get these people the help they need early so their issues don’t overwhelm them, Fishback said.

Her staff’s ability to do that is hampered by a lack of available space in the building at 211 Fourth St. in Brookings – even conference rooms and break room space have been converted into offices for the staff that’s been added over the past few years, Fishback said.

She needs more staff, but has nowhere to put them, so Fishback is worried about her organization’s ability to keep helping the people of Brookings and surrounding areas when demand for their services is increasing. She isn’t just thinking about the next year or two; she’s looking 40-50 years down the road.

“We need to expand our building, so we’ve got appropriate office space and group space available,” Fishback said.

“Our board of directors has assessed all options at this point,” Fishback said. 

Her goal is to renovate so they can stay in the same location, which is familiar to their clients and near the other entities they work with.

“We’re close to downtown; we have good access to some of our community partners,” she said. “Our clients that utilize BATA have easy access to us … So there are some real benefits to being located here.”

What they do

Brookings Behavioral Health and Wellness provides “a broad array of mental health and substance use services,” Fishback said, including therapy for individuals, couples, families and group-based clinical care.

“Our goal is … to meet the individual where they’re at and provide the level of care that is most appropriate to maintain safety of that individual,” Fishback said. 

They do case management, which is individuals with chronic serious mental illnesses. That covers almost every aspect of care, including housing, Social Security and disability benefits, and connections to other community resources, Fishback said.

“We also have a systems of care program which falls under our mental health services and that is predominantly geared towards youth and their families,” Fishback said.

The family case management services cover financial needs, housing, food insecurity, and similar needs that affect life quality and mental health and emotional functioning, Fishback said.

“We work in partnership with Avera Behavioral Health Outpatient Services to provide school services to youth in all of our Brookings County schools,” Fishback said. “We are able to see kiddoes actually in the schools. We work with teachers and school counselors to identify kids in need.”

Seeing the kids in the school building reduces the need for parents to take off work and bring the child to the BBHW office.

Their substance use services include addiction recovery.

“We offer group-based services for substance use as well as work closely with, for example, our state’s attorney’s office, to provide diversion programing,” Fishback said.

They provide crisis services to Brookings County and work with the Brookings Police Department, Brookings County Sheriff’s Office, the jail, Brookings Health System, and all of the schools in the county, including South Dakota State University, she said.

BBHW offers emergency services and her clinical staff is on call at all times.

“We provide 24/7/365 mental health/substance use crisis services,” Fishback said. “At any time, day or night, an individual can call our main line office number and speak to a person. … The individual on call is one of our clinicians, one of our counselors.”

No room for staff

Fishback has 17 clinical staff members, 14 of whom are primary counselors or case management, providing mental health and substance use services. The other three are a full-time physician assistant, a full-time registered nurse and a psychiatrist who is there two days a week, Fishback said.

That doesn’t include her or her administrative team, which would be six additional people.

She has three open positions and wants to get two interns this summer.

And she doesn’t know where she’s going to put them.

“We’ve got a small building. This building was built in the ’70s, and we’ve occupied it for the whole time since then,” Fishback said. “We have really done everything that we can at this point to maximize the space that we have within our existing structure.”

“All of our offices are full of staff and because we have grown our staff over the last couple of years, we have gotten pretty creative, I think,” Fishback said.

“We’ve turned … storage rooms into office space. We have split off what previously were break rooms and conference rooms into office space just to allow us to hire additional staff,” Fishback said.

The offices are the size of a walk-in closet or a family-style public bathroom and sometimes are shared by more than one staff member. 

Different staff members might need more room than others, if they’re working with a family of five rather than an individual. 

Privacy is paramount and right now, Fishback’s staff is using machines that make white noise to help ensure their clients’ privacy.

Fishback knows the space limitations are hampering her staff’s ability to do their jobs, and she’d determined to get it fixed so they can continue to help their clients because the need is so great.

More call for services

Her staff is in demand more than ever, and it’s just the times we live in, Fishback said.

People are under more pressure these days, whether it’s related to fears about contracting COVID-19, losing their job, rising inflation, people panicking over how they’ll pay their bills, addictive behaviors like alcohol and drugs or the array of mental health issues, like depression and anxiety.

“It really is all of those,” Fishback said.

No matter what problem anyone has, she wants people to seek help early and not wait until the issues get bad. There’s more focus on mental health “and really helping to reduce the stigma associated with seeking services,” Fishback said.

“We are seeing an increase in people that are reaching out for help when they’re experiencing maybe a situational stressor,” Fishback said. “They’re reaching out for help, early and often, instead of waiting until things become a crisis.”

Unfortunately, crisis situations are on the rise.

“Right now, we’re averaging 40 crisis calls a month,” Fishback said earlier this year. That’s “close to doubling” what it was from last year.

Crisis calls can vary in intensity and time needed to handle the situation. It could be someone who just wants advice on how to deal with a situation and the staff can de-escalate the crisis on the phone, or “an individual that is actively suicidal in the emergency room, that … we’re spending multiple hours with … but for us, crisis means whatever is a crisis for that individual at that time. So we don’t quantify crisis.”

There’s been a 7.5% increase in the number of clients they see in a given year, specifically from 2020-2021. 

“Just given the numbers that we’ve seen, we’re estimating that the increase from 2021 to 2022 will be 17.5%,” Fishback said.

She looked at the number of visits per month for the past six months.

“We’ve had, on average, just under a thousand visits each month. And that is a 14% increase over the same six-month period last year,” Fishback said.

That’s about 33 visits a day, she added.

“Our average number of new referrals each month is about 118,” Fishback said. “That is a 28% increase over the same period of time for last month.

Referrals can be made by medical professionals or an individual can self-refer, too. 

“Those referrals can come really from any source. We have no wrong way to get into our doors,” Fishback said.

She wants people to seek out Brookings Behavioral Health and Wellness, because she wants them to get the help they need, because that is better for everyone.

“From my standpoint, as an agency, our primary concern is making sure that we have the infrastructure we need to be able to continue to provide the services that are needed within Brookings County,” Fishback said. “We want to do that in a high-quality way that supports our clients.”