Mental health forum focuses on what works, what needs improving - Grand Rapids (MN) Herald-Review

Marie Nitke
November 28th, 2007

About 100 people from the Itasca County area participated in a legislative forum on mental health held at the Grand Rapids Area Library Tuesday night. People with mental health issues and their friends and family joined local mental health services professionals, Minnesota Senator Tom Saxhaug, state Representatives Loren Solberg and Tom Anzelc, and Executive Director of the National Alliance on Mental Illness (NAMI) of Minnesota, Sue Abderholden, to talk about what’s working and what needs improvement in the current state and local mental health system.

“This last year was a banner year for mental illness funding at the legislature,” said Abderholden, citing about $34 million in new funding. “But it still wasn’t enough. Next year, we want to try and make up for what was missed this year.”

According to Abderholden, NAMI-MN will be seeking funding in the next legislative session for the following key issues:

• Health Care

One of the biggest flaws in the national and state mental health care system, as discussed at the forum, is the overall lack of mental heath care available at general health care centers.

“There’s too much disconnect between health services and mental health services,” said one community member. “Hospitals seem to ignore the fact that the brain is a part of the body, too.”

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“If a person was sent to the emergency room because of a cardiac arrest, that person would be attended to immediately,” said another community member. “Yet people who are in the emergency room because they are suicidal are left sitting in the waiting room, or are sent home, but they’re in just as much danger of dying.”

Abderholden and others commended the local mental health services system, citing innovative initiatives like the Crisis Response Team, which recently won a state award. Still, insiders pointed out that improvements are still needed in certain areas. Itasca County Family and Children’s Services Manager Marian Barcus, for example, said that mental health services professionals run into complications when trying to find a place willing to treat people with “dual disabilities” (such as a person who is both mentally ill and an alcoholic). Barcus said she’d like to see state regulations loosened to enable hospitals and mental health facilities to treat patients with dual disabilities.

Other mental health professionals at the forum said that rural health care centers are not given access to the same resources as those in metro areas, and asked legislators to ensure that funds are allocated equitably throughout the state.

• Health Insurance

“People need access to health insurance in order to pay for mental health treatment and medication,” states a NAMI-MN brief on it’s key issues for 2008.

NAMI-MN’s plan to ensure health insurance for the mentally ill is accessible includes deleting the four month waiting period under MinnesotaCare, continuing coverage until age 25 for youth with mental illness who are living in the child welfare system, and eliminating barriers to integrated care.

“We need a continued, even, seamless health insurance coverage option for people who have a chronic disease,” said Itasca County Health and Human Services Director Lester Kachinske.

As the current system works, pointed out another health care professional, there are fairly frequent breaks in heath insurance coverage for the mentally ill, and it is usually during those times that medications are not taken, making social, behavioral and even criminal problems more likely to arise.

• Housing

Abderholden said people with serious mental illness need stable housing with a support system in place in order to live in the community and to avoid costly hospitalizations and residential treatment. NAMI-MN will be seeking additional funds from the legislature to create more affordable housing options for the mentally ill.

• Work

Abderholden said the unemployment rate of the mentally ill is nearly 90 percent. Thomas Cook, Director of Children’s Mental Health Services, who recently moved to Grand Rapids from Wisconsin, said the biggest gap in opportunity for the mentally ill that he has noticed in the Itasca County area is employment. NAMI-MN will be seeking legislative funds to support employment, hoping to decrease the unemployment rate, and to initiate more programs that encourage employers to hire the mentally ill.

A related goal of NAMI-MN is to raise pay rates and offer more fringe benefits to mental health professionals, psychiatrists and clinical nurse practitioners. Abderholden said Minnesota is one of the bottom 15 states in the United States in terms of what it pays these professionals, which has resulted in a work force shortage.

• Criminal Justice

“A high percentage of people with a serious mental illness end up in the criminal justice system due to a mental health crisis,” states the NAMI-MN brief. “Minnesota needs to develop more mental health courts, jail diversion programs, mental health programs in the jails and discharge planning.”

• Children’s Mental Health

The use of seclusion (such as time-out rooms) and physical or mechanical restraints on mentally ill children in classrooms was a topic that most people at the forum took issue with.

A former public school teacher said such tactics can be necessary if a child is endangering himself or other children (such as if a child is threatening another child with a pair of scissors). Abderholden agreed, and said NAMI-MN is asking legislators to create additional regulations to discourage and monitor the use seclusion and restraint procedures -- not do away with them entirely -- in the interest of student safety.

• Other issues

People at the forum offered other suggestions on how to improve mental health services. One woman, for example, said she’d like to see more programs that help mentally ill parents raise their children. Another community member said he’d like MinnesotaCare eligibility requirements to be based on need and individual situations, and for the process to be less complicated. Other community members hoped for quicker, more seamless health insurance coverage for mentally ill veterans of the military.