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When her mother and stepfather relocated out of state, Marissa Wegner found herself visiting youth drop-in centers in St. Paul, Minneapolis and Bloomington to pass her days. Wegner, who grew up in Rosemount and lives in public housing in St. Paul’s Cathedral Hill neighborhood, aged out of youth programs when she turned 25, leaving her with few social outlets.
Then came the pandemic, which further isolated her — an especially scary place to be for a person struggling with lifelong mental illness.“During COVID I went stir crazy,” said Wegner, 28, who said she lives on the autism spectrum and suffers from depression, anxiety and attention deficit disorder.
She found the community she was looking for at Vail Place, a nonprofit service provider that runs “Clubhouse”-themed day centers offering adults with mental illness structured activities in Minneapolis’ Uptown neighborhood and Hopkins. She’s kept busy discussing pets on the Vail Place podcast, and on Thursday, she spent the early afternoon weaving decorative baskets with fellow Clubhouse member Martha Bird, a registered nurse who discovered Vail Place after a back injury left Bird spiraling into depression.
“It’s like a second home,” said Wegner, who appeared in a Clubhouse musical production last year during a ballroom fundraiser in Golden Valley, fulfilling her lifelong dream of taking the stage.
Margaret Humphrey, a former senior planning analyst with Hennepin County Human Services, recalled the mental breakdown that led her to 11 weeks of partial hospitalization and outpatient care at Hennepin County Medical Center. A group counselor, Chad Bolstrom, suggested she look into Vail Place for social supports. That was 10 years ago, and she’s been a regular member ever since. Bolstrom is now the nonprofit’s program director.
At Vail Place, “you matter here. It’s kind of like the mental illness version of the ‘Cheers bar’ — they know when you’re having an off day,” Humphrey said. “I can come here and say ‘I’m changing medications’ and everyone will groan together, because they know how hard that can be.”
“When you come out of all of these hospital programs, you go from having all this attention and support and kindness and compassion — and then there’s just nothing,” added Humphrey, who lives in St. Paul’s Hamline-Midway neighborhood. “Everything is focused on crisis for the last five years. We don’t have anything (in the east metro) focused on just keeping people stabilized in the community.”
Seeking expansion and new funding
Karina Forrest Perkins hopes that may soon change.
Perkins, who was appointed executive director of Vail Place last October, is pitching the Clubhouse model to Ramsey County, officials in greater Minnesota and state leaders in hopes of opening more day centers statewide.
“It is not medication or a therapist visit,” she said, noting as many as 40 percent of members hold some form of employment. “It’s what you need every other day of your life when you’re in crisis. … (But) there is not a rate structure to support it.”
Last year, Hennepin County cut its longstanding state block grant funding for Vail Place by half, dropping it by nearly $1 million over a two-year funding cycle, in order to free up state-backed “Adult Mental Health Initiatives” (AMHI) dollars for more culturally specific treatment programs. That’s left the nonprofit scrambling to fill budget holes at the same time it has been looking to expand.
There have been other challenges. During the early days of the pandemic, certain services went hybrid or online entirely via Zoom, which has been a mixed blessing.
“The pandemic kind of did a number on us,” Bolstrom said. “Mental illness is often by its nature distancing from people and support structures.”
Discussions with Ramsey County over the past six months have focused on the possibility of funding a Clubhouse location somewhere in the east metro. At the same time, Perkins said Vail Place has engaged state lawmakers in potential funding strategies that could support similar sites across Minnesota. Some 28 states help back Clubhouse-style centers for the mentally ill, with most using state-administered Medicaid reimbursement to cover costs. At the Uptown and Hopkins locations, Vail Place does not charge members a fee, and even made-from-scratch lunches are $2.
“There is an active coalition in Ramsey County that has been wanting this for years, and we are now in a very intentional, strategic partnership to achieve that goal for them,” Perkins said. “From a mental health perspective, our state is increasing in crisis. We are not reducing demand for mental health. In fact, just the opposite — more people are needing mental health supports, and fewer people are receiving it.”
Alongside former state Rep. Andy Dawkins of St. Paul, former state Rep. Mindy Greiling of Roseville is co-chairing a committee on the Vail Place expansion effort for the Ramsey County affiliate chapter of the National Alliance on Mental Illness, or NAMI. Greiling, who has written a book about raising a son with schizophrenia, said she was impressed with the nonprofit’s upbeat environment — a far cry from the dismal halls of many a psychiatric ward — as well as its transitional job placement program, which has placed workers at Kowalski’s Markets and the Sea Salt Eatery in Minneapolis.
Greiling noted that the first Clubhouse was started in New York City in 1948, and certified Clubhouses can now be found in most U.S. states and 30 countries. While membership is free, it comes with more responsibility — members agree to stay engaged in activities from 9 a.m. to 3 p.m. — and opportunity than a typical drop-in center.
“It’s a totally different model, and it’s evidence-based,” she said.
A future in Ramsey County?
Bolstrom said all seven members of the Ramsey County Board of Commissioners have conducted site visits at the Uptown or Hopkins locations, centers that could be mistaken from the outside for residential homes.
Trista MatasCastillo, chair of the Ramsey County Board, said while several county commissioners have expressed interest, the board as a whole has yet to host a formal discussion.
A likely next step would be to partner with a local chapter of NAMI to form a working group. Key questions would entail what level of partnership the county would provide, and whether the relationship would fall under county social services, workforce or another department. No funding decisions are likely this year, she said.
“I think there’s a lot of things to explore in this scenario, but we recognize there’s a gap and a need,” MatasCastillo said on Friday.
To expand the Clubhouse model statewide, authorizing Medicaid reimbursement would take state action, including determining whether Medicaid would cover Clubhouse services by the hour through a fee-for-service model or through some form of subscription bundle. And within either option, those reimbursements could be structured different ways, Perkins said. Discussions with the state Medicaid office are ongoing.
‘The whole spectrum, like how we should be painted’
Mark Jensen said he spent six weeks in an induced coma in 2009 while suffering pneumonia, and emerged “scrambled” and depressed. Antipsychotic medication packed on the weight.
“Up until eight years ago, I was basically making it through the day liquored up, hating everything,” he said.
That’s when he discovered Vail Place, where he’s immersed himself in myriad duties, from podcasting to serving on the nonprofit’s advisory board. Jensen said he has lost 150 pounds in the past two years alone and recently moved into a new apartment. He’s also quit drinking and formed close bonds with staffers.
“Staff time is really important for us,” Jensen said. “We don’t need the level of care like you’d get in a hospital, but we need more than (the typical person) living alone.”
For the past nine years, a writing group associated with the History Theatre in downtown St. Paul has put on an annual performance of stories from Vail members. Following the May performance, which he helped to record, Jensen said he walked away humbled.
“This was my first History Theatre performance to experience, and it was in many ways a different performance than I was expecting,” said Jensen, in an email Friday. “Some stories I too have experienced firsthand, but some told the pasts of my fellow Vailers that I didn’t know, and now I look at them as stronger, funnier, more real people than I was allowing them to be in my mind. I came down with my illness after the coma, and I, having lived this life only since 2009, can sometimes paint us all with a single dark acrylic instead of the whole spectrum like how we should be painted.”
Grace Rinehart, a doctoral candidate in occupational therapy at the University of Minnesota, has spent much of late June and July shadowing workers at Vail Place, and she’s been impressed by a go-at-your-own-pace attitude toward helping members apply for social services, conduct job searches and engage with other duties.
“It helps to find that balance, when to jump in to help, and when to actively listen,” Rinehart said. “Clubhouses like these need to be better publicized.”