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Midwest Opinion: Minnesota struggles on mental health problems

While other states aren't making new investments to treat mental illness or are even cutting programs, "We've done a lot as a state investing in mental health," Minnesota Department of Human Services Commissioner Emily Piper said in aninterview T...

While other states aren't making new investments to treat mental illness or are even cutting programs, "We've done a lot as a state investing in mental health," Minnesota Department of Human Services Commissioner Emily Piper said in aninterview Tuesday with the Duluth News Tribune.

"In 2015, we had really significant investments in community mental health. (Then, this) last (legislative) session, we invested in our own direct care and treatment hospitals, our health system. We didn't get all that we needed, but we got really significant investments," Piper said. "We're really unique as a state in that we are acknowledging and recognizing that the need for investment is ongoing and that while what we've done is really significant it's not enough."

Not only is Minnesota's investment in mental health not enough, despite the dollars allocated, the state is still struggling to get a good grasp of the problem and what to do about it. There's no comprehensive, ongoing strategy to treat and manage mental health problems going forward. And this is decades after Minnesotans with mental illnesses were freed from sometimes-inhumane institutions in favor of being treated as members of their communities.

It wasn't until just this past April that Gov. Mark Dayton, via executive order, convened a task force on mental health, its members including Piper, psychiatrists from the Mayo Clinic and Allina Health, community-based mental health providers, a judge, law enforcement officials and others, including others affected by mental illnesses. The long-overdue task force will advise the governor on gaps in coverage and opportunities, and on what needs to be happening to effectively treat people who are suffering.

Recommendations are expected this fall. Piper hopes they inform spending and treatment decisions for years to come.

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"This isn't a problem that can be dealt with in one legislative session," she said.

Especially with a Legislature that couldn't even get a bonding bill passed during a bonding year this session.

Still, two years ago, the Legislature did allocate $46 million for the state's seven community mental health facilities.

This year, $28 million went to group homes, $12 million went to address staffing shortages in behavioral health hospitals, and $800,000 went to the state's main mental health hospital in Anoka. As impressive as those numbers may sound, that nearly $41 million this year was still far short of the governor's suggestion that there were $166 million of needs.

Hospitals and communities across the state have been left to feel alone in trying to address what really is a statewide and national issue, Piper said. More police calls involve suspects with mental health challenges. Emergency rooms are filling with patients with mental illnesses who really shouldn't be there but have no place else to go. Some patients stay years in emergency rooms not getting the help they need because there's no place else for them.

Then there are the disparities. More services are available in larger cities. More services are needed by communities of color. How can services be provided fairly and to all who need them?

If there's any comfort to be taken in Duluth it's that the commissioner feels "Duluth is doing a really good job." The Duluth Mental Health Task Force made a presentation to Piper and the rest of the governor's task force on mental health issues Tuesday when they met in Duluth.

"(Duluth's) cross-sector collaboration is good with law enforcement and community-supportive housing folks and law enforcement bringing social workers into law enforcement to try and respond to some of the mental health calls that they get, having them around the same table with the psychiatrists from the local health systems. It feels like (Duluth) is ahead of a lot of different places in the state with people who are talking to each other, trying to work together, trying to information-share even across the health systems about what they're seeing and what they're dealing with and learning," Piper said. "But again, it's a bigger problem than what the Duluth community can solve, and that's really where I and the rest of the state government needs to say, 'How can we better support you?' ... Communities like Duluth are trying to find their own answers to these challenges, but they also feel a lot of pressure like they can't do it all themselves. (There's) constant tension."

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Meaning a lot is riding on the recommendations this fall from the governor's task force. Minnesota may have more people with mental illnesses living in communities while being treated rather than in institutions that can seem cold or inhumane, but our state, like all states, continues to struggle for answers. And even to determine the right questions. At least here, some investments are being made. And efforts like the governor's task force.

"It's really challenging," Piper said. "I see the challenges that our hospitals have. Success to me is fully funding them and making sure that our patients have the treatment that they need and our staff is safe. Anything short of that just means more work is needed."

More work definitely is needed.

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