Consultants advise North Dakota to team up to push through reforms of state’s ‘broken’ mental health system – InForum

BISMARCK — Advisors are urging North Dakota to use an implementation team to drive reforms to the state’s “broken” mental health system, which has been in a recognized crisis for a decade.

The recommendation was one of many presented in a final report received on Thursday, April 28, by an interim legislative committee studying ways to fill service gaps for people with mental illness.

“The key to moving this forward is having someone to keep an eye on things,” said Jason Haglund of Renee Schulte Consulting, a firm that heads the Acute Psychiatric Treatment Committee of the North Dakota Legislature.

A powerful champion will be needed given the complexity of the issues involved which will take several years to address, he said.

“North Dakota nice is really something,” Haglund said. “It helps to have a buffer.”

sen. Kathy Hogan, D-Fargo, agreed that encouragement and persistence will be needed to make the changes needed — the urgency of which was underlined by testimonials from family members frustrated with the system.

“It won’t happen without a solid, solid leadership,” Hogan said.

Representative Jon Nelson, R-Rugby, chairman of the committee, noted that the committee was formed to examine what is needed in a new state hospital, which has broad support.

“This is much bigger than a large building,” he said, adding that he “has learned over and over again how broken the system is.”

The consultants also recommend North Dakota conduct a tax audit of the state hospital and regional human services centers to get a detailed picture of how the state spends money, monitor trends and find ways to improve efficiency. increase.

sen. Judy Lee, R-West Fargo, agreed that periodic audits would be helpful and suggested hiring independent auditors with healthcare expertise.

Rosalie Etherington, chief clinics officer and superintendent of the State Hospital, said crisis services have increased by 65% ​​in the past 12 months, even though the system was only fully operational for six months.

“We expect it to rise around this time next year and double from what we have now,” she said. Human services officials have partnered with the 36 critical-access rural hospitals in North Dakota to provide crisis mental health services, which are also available at each of the state’s eight regional human service centers.

The state has doubled the service to the Cass County Jail from both the Southeast Human Service Center and the State Hospital, but Lee said the services are inadequate for the high levels of mental illness among some inmates.

Nelson said he heard about it from law enforcement in his district and elsewhere in the state. “They are frustrated that there are no treatment services available to them,” he said.

“There is more need than we can currently provide,” Etherington said, adding that state providers sometimes miss important information about the patients they receive. “A good assessment relies on good information,” she said.

“You can use telepsychiatry to a much greater extent than it is used now,” Haglund said. “You absolutely can do this.”

Nearly half of calls for crisis services are in the Fargo region, Hogan said, adding that this could be partly because the crisis response system started in Fargo.

Noting that “the demand for services in Fargo is greater than any other human service center,” Etherington said, “there is greater dissatisfaction in the Fargo region for that reason.”

Lawmakers and counselors have received numerous complaints from family members frustrated by the system’s failure to help their loved ones. Those complaints need to be formally recorded and analyzed to point the way to improvements, Haglund said.

“You all need a breakdown hotline,” he said.

An example of this came from Jeanne and Rebecca Anderson, of Moorhead and Dilworth respectively, who spoke of their inability to receive adequate treatment for mentally ill relatives in North Dakota. All too often they found it difficult to get treatment and even when treatment was available, the hospital stay was too short to be adequate, they said.

“Extended time of care is needed, and it should be mandated,” said Rebecca Anderson. Relatives have had to wait too long for help and their mental health has deteriorated, sometimes causing them to break the law, she said.

Carlotta McCleary, executive director of Mental Health America in North Dakota and a spokeswoman for the Mental Health Advocacy Network, supported the report’s findings and recommendations, including a new state hospital, tax audits and extensive peer support services.

The interim commission is working on legislative proposals to be presented at the 2023 session.

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