When it comes to providing mental health care, Minnesota counties provide a valuable safety net, and they do so at significant local expense. Typically, 40 to 50 percent of Minnesota counties' budgets are spent on health and human services for county residents. Timely and appropriate mental health treatment is a crucial part of the human services that counties deliver.

The need for mental health care varies greatly from county to county and even from city to city around the state. Given the diverse range of environments and populations found in Minnesota, it makes sense that the need for county services — especially mental health services — will vary from community to community. Nobody would expect the needs of Hennepin County residents to mirror the needs of those in Kittson County. Because demand for these services is felt locally, the ability to react to that demand and adjust the funding for mental health care should also be maintained locally.

Unfortunately, too many restrictions have been put on local governments that tie the hands of county officials when it comes to service delivery. Often these mandates do little more than eat up limited resources and don't actually improve the quality of care. When it comes to knowing how best to provide for the mental health needs of local residents, a mandated "one-size-fits-all" prescription from the state is not the solution. 

Focus on results, not dollars spent
The problem is that the state puts too little emphasis on results. Minnesotans, regardless of whether they live in St. Paul or Warroad, should have access to effective mental health services that focus on recovery and wellness. The state's mandate focuses on dollars spent rather than achieving wellness. That approach won't improve the care of Minnesotans suffering from depression or other mental health illnesses.

Especially in these trying economic times, legislators must work to allow counties the flexibility they need to target and tailor limited resources to maximize results. This is the best way to serve those needing mental health services and the local property taxpayers, too. Strengthening the partnership between the state and counties will go a long way toward healing the system of delivery — not only for mental health services, but for all services administered by the county.

If clients' needs are not being met by county mental health care currently provided, let's fix it to ensure they get the care they need. There are bills making their way through the legislative process that would be a reasonable compromise to the concerns of counties and mental health advocates alike. 

As legislators continue to work on this important public health issue it is critical that they continue to recognize both the continued need for mental health care and the counties' need for flexibility in dealing with this and other services. When it comes to the mental health requirement for county government, lawmakers should follow this simple mantra: Mend it, don't end it.

Toni Carter, St. Paul, is a Ramsey County Commissioner.