WATERLOO — Two-by-fours and plywood are starting to take shape for a space that will be the first step in building a new life for many area residents.

Pathways Behavioral Services’ new detox facility is scheduled to open Dec. 31, said the organization’s executive director Chris Hoffman.

The eight-bed, 3,200-square-foot center — which will be attached to Pathways’ residential treatment program on University Avenue — has been needed for years, Hoffman said. He said this is because of an increased awareness of treatment, which has spurred residents to encourage their friends and family members to seek the help they need at a time when hospitals are retreating from the detox business.

“We wanted to do this for probably 10 years and couldn’t get all the stars right,” Hoffman said. He said the treatment agency ultimately decided to build the $850,000 addition. UnityPoint Health-Allen Hospital donated the beds, he said.

The upcoming facility also is a victory for the Black Hawk County Stepping Up Committee, a volunteer organization that is focusing on measures to divert the mentally ill from jail, said Linda Laylin, a Black Hawk County supervisor who serves on the committee.

Sheriff Tony Thompson welcomes the Pathways expansion because it will alleviate pressure on space at the county jail, and he supports other initiatives to support people who need mental health and substance abuse help.

“There is such an acute need across the state of Iowa and Black Hawk County,” said Thompson, who was on an Iowa Department of Human Services task force on the issue.

“I hate the fact that somebody comes to jail with an extreme mental illness, and the best thing I can offer them is segregation. … Criminalizing the mentally ill simply because we don’t have any other option or opportunity to place them someplace else, that’s just not the right answer,” Thompson said.

Pathways’ medically monitored detox center will house up to eight people for three to five days while they ride out withdrawal. A full-time medical doctor or nurse practitioner will be on staff, supported by five nurses and four CNAs and other workers.

Hoffman said patients who need medically managed detox — a higher level of treatment because of the risk of death — will be referred to a hospital for treatment.

After detoxification, the patients can transition into the 28-day residential treatment program located in the adjacent building.

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Hoffman said having the two facilities physically connected is crucial because patients are more likely to follow through with the treatment. Only about 15 percent of people who go through detox will continue on to treatment if the treatment facility is located elsewhere. For operations where the detox and treatment facilities are connected, the transition rate is 75 percent, Hoffman said.

“We can increase the follow-through dramatically by doing it this way,” he said.

The Stepping Up Committee was launched in September 2015 when the Black Hawk County Board of Supervisors approved a resolution to divert people with mental illness from incarceration. The group of about 20 corrections, court and treatment representatives meets monthly, and in 2016 members traveled to San Antonio, Texas, to tour the Restoration Center, which boasts detox — similar to the new Pathways facility — psychiatric care, transitional housing and other services.

As part of the Stepping Up initiative, staff at the Black Hawk County Sheriff’s Office have been taking Crisis Intervention Training, Mental Health First Aid and Trauma Informed Training, and courses that develop “soft skills” like listening, understanding and compassion, Thompson said.

“Those are more tools in an employee’s toolbox to help with dealing with people in crisis, better understanding people who have been through trauma, people that have mental illness,” he said.

Law enforcement is usually the first response to most types of crises, and it quickly becomes evident when the person involved simply needs help, Thompson said.

“Instead of arresting them on a simple misdemeanor — disorderly conduct or trespassing — divert them into where there is more appropriate treatment and more appropriate response for them,” Thompson said.

Stepping Up also helped the court system implement a Fast Track probation procedure to deal with offenders with probation violations as a way to alleviate jail crowding.

Normally offenders who accumulate a number of probation violations are placed in jail pending a hearing. But this can be a drawn-out process, and the offenders risk losing jobs or housing in the interim.

Fast Track, which was put in place in 2017, is designed to address routine violations as they arise instead of waiting for number of violations to pile up.

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