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WILLMAR — As the mental health authority for the county, Kandiyohi County Health and Human Services provides needed programs and treatments for residents in need.
"There is a list of required services the county needs to provide," said Corinne Torkelson, supervisor for adult mental health.
Those services cover both adult and children's mental health, and the county is seeing growth in both. So much so that the department has decided to split adult and children's mental health into two units.
"We are in the midst of doing some transition," said Jennie Lippert, Health and Human Services director.
While there wasn't enough time during the Oct. 18 meeting of the Kandiyohi County Board to go into everything Health and Human Services handles when it comes to mental health, Torkelson and Lippert hit on some of the bigger challenges.
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"We are seeing growth ... in terms of the challenges and different areas we are seeing needs locally," Lippert said.
In adult mental health, Kandiyohi County finished 2021 with 87 open cases. That has grown to 97 cases so far this year.
"It isn't a huge jump, but it is a jump," Torkelson said.
When you are short-staffed though, any jump in caseloads can be an issue. The department has been down one staff member in its mental health division and has been struggling to fill it. That means the remaining workers are stretched even further.
"More work, less staff creates some limitations in what our staff are able to do," Torkelson said.
Another area of adult mental health that has seen an uptick in cases is commitments. As part of its mandated services, the county must complete pre-petition screenings for any case in which a person would be committed involuntarily for mental health reasons.
The process starts with a case worker receiving a statement(s) in support of commitment, usually from a medical professional, supporting the commitment of a client because the person is seen as a danger to themselves and/or others.
The case worker will speak with the client and others, to get a grasp of the current situation and whether the danger rises to the level of commitment.
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If the county believes there is a case, they will forwarded it to the county attorney who will then decide whether to file a petition for commitment. It then goes to a judge.
"The court has the final determination if someone is committed or not," Torkelson said.
Typically, Kandiyohi County deals with about 40 to 45 screenings a year. Last year there was a big jump.
"2021 was a really high year for us; we had 62 screenings that we did on commitments," Torkelson said.
Of those 62 screenings, 44% were screened out, meaning they were not forwarded to the county attorney. This could be because the case did not meet the legal level for commitment or because the individual agreed to enter into treatment voluntarily.
This year the county has already done 43 pre-petition hearings and only nine of them have been screened out. The reasons for the greater number aren't specifically known, though the coronavirus pandemic might still be playing a part.
On the children's mental health side, county staff is seeing concerning growth, especially this fall. From Sept. 1 to Oct. 16, there have been 15 new cases, up from six over the same time last year. And these aren't simple cases, but ones with children dealing with major issues.
"We are seeing younger then we have ever had," Torkelson said. "We are also seeing children who are much more challenged in their mental health needs then we have ever seen before."
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Part of these complicated cases is trying to find a space for the child in a specialized treatment center if needed. That can be extremely difficult nowadays with fewer and fewer places available and the need growing. Sometimes it can take months to find an open spot.
There are similar issues on the adult side as well.
"There are frequent, frequent phone calls that are being made in attempts to find appropriate placements," Torkelson said.
Lack of beds can also be expensive for the county, especially when a client no longer meets the requirements of a certain facility and the prices go up. For an adult who is staying in a state-run program but no longer requires that level of care, it can cost the county from $1,700 to $2,500 per day. Usually the fix would be to move the person to the next level of care, but often the county can't find space.
"Definitely budget busting," Torkelson said.
The belief of both county staff and the County Board is mental health will continue to be a need and a challenge. Most likely new ways of providing those service will need to be established.
"There is a lack of resources, and I think counties are going to have to start looking on how we proceed," said Commissioner Corky Berg.
