6/18/2015 1:33:00 PM Mental health regional players meet in wake of Riverwood shutdown
by DENISE MARTIN
Riverwood Center, Mora, used to be the clearinghouse and base of operations for a variety of services for mentally ill persons in east central Minnesota including Chisago and Isanti counties.
The abrupt collapse of that private program, however, left mandated service providers scrambling to fill all sorts of gaps in mental health needs and resources.
Federal and state laws require there be certain levels of service available to address psychological needs and the funding that counties receive through specific block grants is tied to providing this service.
Funds for everything from court-ordered chemical use assessments, to staffing a jail nurse capable of prescribing medications, to group home funding and school behavioral specialists relies on there being a functional system to support the work.
A positive but unintended effect of Riverwood locking its doors is: a host of people working in this field, who haven’t really spent much time talking amongst themselves, have been coming together.
Nancy Dahlin, Chisago County HHS Director, commented at a recent update session on the east central region mental health assessment and survey, which was started after Riverwood closed, that this hasn’t been undertaken for many years.
About 30 people working in the mental health network met in Center City to review themes and concerns coming out of the survey and assessment, with results being complied by the Improve Group.
The main issue rising out of this gathering was the need for “crisis” services and a facility.
And, the county jail seems to have a pivotal role to play.
Assistant Chisago County Jail Administrator Chris Thoma said he would estimate 30 to 50 percent of the inmates are using some kind of prescribed mental health medication.
A big problem in his daily schedule will be when he gets an order from the court to release somebody, but he often doesn’t have anywhere to release them to. The day this regional group was meeting there were four inmates in this category, he said, who were detained on disorderly or assault charges because of injurious behavior at their local group homes.
Thoma said he can call around for another facility bed (usually a hospital) to send these people to, but the capacity just isn’t there.
A representative from Fairview echoed that concern about space. She added an example how one person racked-up 146 emergency department visits because there were no other facilities where they felt they could get attention.
Thoma said jails or hospital emergency rooms are where law enforcement personnel end up bringing people acting-out dangerously or who are a public nuisance due to their inability to function. There’s needs to be a local program and a place to handle mental illness-related offenders.
(See sidebar on Hennepin County’s similar concerns and pending federal legislation.)
“Mobile Crisis” response teams are in operation in all but 13 counties in Minnesota.
Chisago County is without a team. According to Mental Health Minnesota, mobile crisis responders are key to addressing hospital avoidance. Stabilization begins to be provided at the first encounter and follow-up connecting the individual to services is part of the approach. Dahlin said the region is working on re-organizing a “crisis team” system.
Thoma said even just having a list of contacts in the area that he could provide to somebody exiting the jail would be helpful.
A case worker in the audience, asked if movement might be headed in the wrong direction and if there were more pro-active counseling and materials provided up front to these individuals, it would help reduce “crisis” arrests and emergency room use.
The discussion turned to the survey findings that many of the consumers of mental health services in this region, said they lacked access to outpatient and case management assistance. All agreed failing to connect with counseling or medications or other services, only costs more later. There were comparisons shown at the meeting of hourly rates to see local counselors and psychiatrists and rates to use a secure hospital bed.
The majority (65 percent) of consumers who answered the survey also said they believe they were able to avoid a hospitalization in the last year, due to having support services available.
The Improve Group gathered input from consumers, group home operators, counseling providers, medical care facilities and the schools, although, according to the survey supervisor area schools provided the least cooperation of any contacted.
And, a high percentage of school professionals who did respond also noted that they feel unprepared to handle mental health incidents in their buildings.
Chisago County HHS Director Dahlin said the idea is to use this public input to layout a direction on “where we should go and what we should be doing.”