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Mental health: Gaps in care discussed at legislative roundtable

Rep. Mary Sawatzky, center, listens to Kandiyohi County Health and Human Services Director Ann Stehn, left, and Mary Kjolsing, director of Behavioral Health at Rice Hospital following a roundtable discussion Saturday in Willmar about shortfalls in mental health services in west central Minnesota. Tribune photo by Carolyn Lange

WILLMAR –– There are not enough beds, services or money to meet the staggering needs of adults suffering from chronic mental illness and not enough is being done to prevent children from spiraling into a mental health crisis, according to local mental health professionals who met Saturday in Willmar during a legislative roundtable.

The discussion was initiated by Rep. Mary Sawatzky, DFL-Willmar, and Rep. Tina Liebling, DFL-Rochester, who serves as chairwoman of the House health and Human Services Policy Committee.

 “We want to hear about your needs,” said Sawatzky, who also asked the group for ideas about how the state can “move the needle” to ensure that people receive the service they need.

The list of problems with the state’s current mental health program cited by the 25 people in attendance –– who have a long history of providing mental health care services in the community –– was long.

There were reports of people suffering a mental health crisis waiting as long as 48 hours at the Rice Hospital emergency room because there was no room at an appropriate mental health facility anywhere in Minnesota. Some patients have to be transported to a hospital in another state.

“It’s heartbreaking to see someone in a psychiatric crisis and they’re in the emergency room and they have to be transferred to Fargo, N.D., to get care,” said Mary Kjolsing, Director of Behavioral Health at Rice Hospital.

This scenario is not just happening in Willmar, she said. It’s happening all over the state.

“If this was happening in any other area of health care there would be an outcry,” said Kjolsing.

Not only is there a shortage of crisis beds, once a patient is eventually admitted to an acute-care facility, they are quickly discharged and bounced to another facility in a different community and oftentimes experience another crisis where the routine is repeated again, according to individuals at the meeting.

When the state closed its large treatment centers, including the Willmar Regional Treatment Center, the plan was to build 16-bed facilities all around rural Minnesota to provide mental health care close to home.

It hasn’t worked out that way, in part because of the difficulty in recruiting psychiatrists to come to small facilities in small towns.

Some of those 16-bed Community Behavioral Health Hospitals have closed, some were never built and those still operating have a different mission than originally planned.

Not only is there a lack of crisis beds, there aren’t enough beds for people the court has committed to a mental health facility and the responsibility oftentimes falls back to counties’ taxpayers –– or in the case of Rice Hospital, city taxpayers.

Kjolsing said a growing number of the mental health care beds at Rice are currently occupied by people with a court commitment.

“We’re providing a lot of free care,” she said, adding that the hospital has plans to add four additional beds to that unit, she said.

There’s also a shortage of group home residential facilities for people who aren’t in a crisis mode but are becoming stabilized before returning home.

The Intensive Residential Treatment facility located in Atwater closed in April, leaving another void in the community.

Time spent at the Atwater facility “helped me get stabilized” and “back on track,” said John Madche, of Willmar, who attended the forum as a consumer of the mental health services. “It was a big influence on where I’m going.”

Closure of the Atwater facility “was a huge loss and we’re really at risk of losing more,” said Ann Stehn, director of the Kandiyohi County Health and Human Services Department.

There was no shortage of complaints about the state’s actions, and lack of action.

The Department of Human Services Department may be “well intentioned” but it has “no grasp of the real world” of what’s needed, said Kjolsing.

A lack of overall funds for mental health locally and across the state was cited as a major issue.

Kjolsing said the state needs to either “take over everything” or else “get out of the business” and provide money to providers.

Several in the group said the money should “follow the patient.”

Oftentimes when one program in the mental health care continuum gets additional funding, a parallel program gets its funding cut, said Corrine Torkelson, a supervisor with the Kandiyohi County Health and Humans Services Department.

“We’re robbing Peter to pay Paul,” said Torkelson.

Liebling said that information was troubling and she would ask for answers on why that was happening.

Stehn also lamented the loss of prevention funds, especially for mental health programs for children.

She said communities are “starting to see the ramifications” of federal and state children’s mental health grants that have been cut over the years. “We’re setting ourselves up for greater problems,” she said.

Children as young as 5 have been admitted to the Child and Adolescent Behavioral Health Services, located in Willmar, which is the only facility of its kind in Minnesota. Some are concerned that this facility may eventually be moved to the Twin Cities.

Calling it a “fragmented and oftentimes inadequate system” that provides piecemeal care to extremely fragile and vulnerable individuals suffering chronic mental illness, Liebling asked the group of longtime community health care professionals to keep providing information so the state can take action to fix the problems.

“I appreciate your voices here,” said Sawatzky.

Carolyn Lange

A reporter for more than 30 years, Carolyn Lange covers regional news with the West Central Tribune.

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