"We're scrambling to figure out how to make this work," she said.

Typically, January through March is one of the busiest times of the year at Oaklawn, said Nafziger. The cuts are the result of reduced Medicaid funding and slow-moving or reduced income streams from a variety of funding sources, said Nafziger.

"We were given very short notice to make these decisions. It gives us, as an organization, minimal time to plan and adjust. That's bad for programs, bad for the kids we serve, bad for staffing and it's bad for families in this community."

Over the past several years, Oaklawn has adjusted programs and often shifts staff into new roles as programs wax and wane. Jobs lost through attrition are not being filled, Nafziger said.

The number of jobs cut last week equals the equivalent of "about 15 full-time positions," Nafziger said. As many as 18 Oaklawn staff were laid off effective immediately. Some were administrative staff cuts, but most were front-line mental health workers who provided personalized mental health rehabilitation and addiction and crisis services. Ten of the 15 FTE jobs are related to on-site residential care at Oaklawn.

On the heels of news last week that Madison Center in South Bend is closing its residential program and cutting 100 jobs, Nafziger said the funding shortage problem is "not as catastrophic here, but it's still bad for the community."

A few weeks ago, five of Oaklawn's residential units collapsed into four units to find savings. The units currently house 49 children and adolescents and are staffed by 101 full-time equivalent positions. The group therapists, individual therapists, psychiatric doctors, social workers and on-site school teachers "are working around the clock, 24 hours a day, seven days a week," she said.

"Nobody sleeps," she said. "You really worry, especially about services for kids, because kids are so vulnerable. We deal with mentally ill kids, and abused and neglected kids, and when you have to cut services at all parts of the continuum, you worry where are kids going to go, and are they going to get the services they need?"

Adults with severe mental illnesses are also in a very vulnerable population, she said.

"You don't want to see people on the streets," said Nafziger.

Over the past year, Oaklawn has felt the pinch of cuts ranging from 3 to 14 percent, depending on the funding source, Nafziger said. In child and adolescent programming, a 9- to 14-percent cut impacts every area of the organization and varies by program.

"The thing is, we aren't taking it (loss of funding) personally. It's all agencies. It's across the board right now. It's arbitrary," she said.

Dr. Jay Shetler is a local private practice clinical psychologist and life coach. Shetler says Oaklawn meets a critical need for people who need help, but can't afford it.

Shetler doesn't fault Oaklawn for the cuts, he said. He commends the organization's history of flexibly delivering programs, but adds mental health professionals agree that cutting adolescent mental health programs leads to critical costs down the road.

Increased delinquency, high policing and justice system costs, long-term joblessness and long-term disability can often be curbed with early intervention and outreach, said Shetler.

Shetler said he hopes Oaklawn, churches and other social service agencies will prepare up-to-date resource lists to help anyone needing access to timely mental health assistance over the holidays and in the New Year.