The Minnesota Department of Human Services’ mental health proposals for the 2015 legislative session focus on further strengthening the state’s mental health system — and filling gaps in coverage in many regions of the state.
The set of legislative strategy proposals, which focus on the needs of children and adults, acknowledge that mental-health concerns are a growing issue statewide. Mental illness affects one in four Minnesotans, the proposals claim, saying state budgets must be adjusted to reflect that reality and support new systems designed to address the needs of the thousands in the state living with mental illness.
In developing the proposals, DHS staffers met with community activists, health care providers and educators to get a clear sense of what is needed to improve mental health care in the state.
Though the proposals were released by DHS, their development was largely a team effort, said Sue Abderholden, NAMI Minnesota executive director: “DHS didn’t just dream these proposals up. They collaborated with the mental health community to develop the priorities for this session and largely listened to us.”
The proposals are likely to gain bipartisan support, said DHS Commissioner Lucinda Jesson.
“There’s been a bipartisan recognition that our mental health system is too fragile,” she said. “Most people in Minnesota know someone who is struggling with mental health problems. The demand for these services is going up. Our capacity for care is limited, and many lawmakers are committed to addressing that reality. I don’t want to speak for everyone, but if you look at the bills introduced in the legislature, you’ll see that both Republicans and Democrats have authored them.”
Earlier this week, a group of legislators and mental health advocates held a press conference to confirm their support for enhancing the Minnesota’s mental health system.
The press conference was held March 10, in advance of Mental Health Day on the Hill, an annual advocacy event sponsored by the Mental Health Legislative Network. The group, which included politicians and health care activists, gathered to show support for further enhancing and improving the state’s existing mental health initiatives. Mental Health Day on the Hill took place on March 12.
“Our theme for this session is, ‘We know what works; let’s build it,’” Abderholden said. “We believe we have a good foundation and we need to make sure that these services that work are fully funded.”
DHS-sponsored legislative proposals for children’s mental health include developing services for young people experiencing their first episode of serious mental illness. Research has shown that prompt treatment after a first psychotic episode may result in better outcomes long term.
“If you are able to provide services for young people when they first show psychotic symptoms, you can push off full onset,” Jesson said. “We want to develop pilot programs around the sate that will identify kids and get them help when they display that first sign.”
Another proposal is to expand the availability of respite care for families of children with serious mental illness. The proposal would provide funding for child-care assistance when parents and other family members need time away.
“We want to be able to help families with children with high mental-health needs take a break,” Jesson said. “Having a respite helps everyone.”
The number of preschool age children diagnosed with mental illness has grown. Jesson said that DHS legislative proposals include earmarking funds for mental health support dedicated to educating and assisting staff at child-care agencies.
“We don’t like to hear about kids being thrown out of preschool,” she said. “One of our initiatives is to provide mental health consultation services for preschools and child-care centers, especially those that serve lots of high-needs kids.”
Another children’s mental health initiative supported by DHS is the establishment of psychiatric residential treatment facilities, in-patient programs where children with mental illnesses can be served closer to home.
“We are proposing the creation of additional psychiatric mental health beds for kids,” Jesson said. “Currently, we think between 300 and 400 kids each year are not getting the service they need. We want to fix that.”
Adult mental health
While mental health care in Minnesota is better than in many other parts of the country, Jesson believes that service levels could improve.
“We’re doing it well in some parts of the state,” Jesson said. “In other parts, it’s spotty. Take mobile crisis teams, for instance,” she said, referring to medical teams that are dispatched to work with a person experiencing serious mental health crisis. “We do that better than most states, but we should have mobile crisis teams available 24-7 in all parts of the state.”
Another key issue is the availability of mental health professionals statewide. In many parts of Minnesota, patients must wait months or travel long distances to see a psychiatrist. The DHS proposal includes increasing capacity to serve individuals with complex conditions.
Because people with serious mental illness tend to struggle with chronic illnesses at a higher rate than the general public, Jesson explained that her department’s 2015 legislative proposals also include further development of and access to behavioral health homes, or teams of health care providers that work with patients to coordinate physical and mental health care in a “whole person” model.
“We are proposing to improve access to behavioral health homes,” Jesson said. “People with serious mental illness die much earlier than others, and have two-to-three times the health care costs.” The behavioral health home approach may help assure that people with mental illness “deal with their physical health before it becomes a crisis.”
Step by step
The DHS proposals make up a long wish list, Abderholden admits. Though there is strong support for many of the programs, she — and Jesson — agree that it will take time to see all initiatives through to implementation. But they are heartened by the bipartisan support, and hopeful that change is on the horizon.
“I think there is support to carry these proposals out over the next four years,” Abderholden said. “The biggest and most important initiatives to us are crisis teams, supportive housing, first episode, early childhood consultation, respite care and behavioral health homes.”
It might also be a good thing if progress moves at a deliberative pace. Jesson admits that there is a need in the state for more health care workers trained in mental and behavioral health.
“That will take some time,” she said, “but we are working on building up the work force to meet the demand.”