An effort to increase treatment capacity at Minnesota’s state-run mental health hospitals is already having positive effects in the regions they serve, said Human Services Commissioner Emily Piper, but those gains are being threatened by proposals being considered by the Minnesota Legislature.
During a visit today to the Community Behavioral Health Hospital (CBHH) in Baxter, Piper heard from area mental health services providers that adding staff and opening more psychiatric beds at the facility has eased some of the strain on local emergency rooms and improved access to treatment for people suffering acute psychiatric crises.
“The goal was to bring all of the CBHHs back up to full strength as quickly as possible, get people the treatment they need in a more timely way, and improve patient flow through our system,” said Piper. “It’s gratifying to see that the investments we’ve made are paying dividends so soon.”
With approval and nearly $20 million in backing from the Legislature, the Department of Human Services late last year began implementing a plan to combat a chronic shortage of psychiatric beds statewide. The idea was to add some new beds to the mix at CBHHs, which provide short-term inpatient psychiatric care, while at the same time freeing-up existing beds in other state-run facilities by transferring patients who no longer need to be hospitalized to a new, more appropriate setting. The approach included gradually ramping up all six of the state’s regional CBHHs to operate at their full 16-bed capacities. Budget constraints had previously limited each hospital to serving only 12 patients.
Dr. Shawna Kovach, director of psychiatric and mental health services at Lakewood Health System in Staples, said having the Baxter CBHH operating at full capacity is a welcome and much-needed improvement.
“The region is really short of psychiatrists and psychiatric beds,” said Kovach. “We can end up boarding patients in emergency departments or psych units for days or weeks while we wait for a bed in a more appropriate treatment facility to open up.”
The increased prevalence of mental illnesses and substance abuse disorders is putting ever more pressure on a mental health system that’s already overtaxed, especially in rural Minnesota. Under such pressing conditions, even four extra psychiatric beds is a big gain, Kovach said.
“This is a common problem throughout Minnesota, so increasing the capacity at all of the CBHHs will help hospitals all over the state,” Kovach said. “And it will be much better for patients. They’ll get the treatment they need faster, and they’ll be on the road to recovery sooner.”
Adam Rees, president at Essentia Health Central, agrees. He oversees a regional health-care system that includes Essentia Health-St. Joseph’s Medical Center in Brainerd and 12 clinics in north-central Minnesota.
Rees said bringing the CBHHs back up to full capacity is a critical step toward improving the mental health system statewide. “The shortage of appropriate 24-hour care for individuals with serious mental illness in Minnesota is a crisis,” he says, adding that the plan is doubly beneficial because it also improves capacity and patient flow at other state-operated mental health facilities.
The CBHH in Baxter has reached its full census with 16 patients and the CBHHs in Bemidji and Fergus Falls are soon to follow suit. CBHHs in Annandale, Alexandria and Rochester are well-staffed and will increase daily patient census to 14 or more as soon as the facilities can hire more psychiatrists.
Piper fears the progress may be greatly eroded as state lawmakers set the budget for the coming two years. Gov. Mark Dayton has proposed spending $44.6 million for the coming biennium and $56.7 million in fiscal years 2020-21 to maintain current staffing and operations. Without the funding, the agency will face a severe financial crisis that will trigger deep staff and program cuts. More than 400 full-time equivalent positions could be eliminated, a very high number of them in the agency’s Direct Care and Treatment administration, which operates the CBHHs and many other facilities and programs for people with mental illness, developmental disabilities, and chemical dependency.
So far, neither the House nor the Senate has included the funding in its Health and Human Services budget bills. The Senate bill proposes operational cuts.
“I’m very concerned about the potential impact on the patients, clients and communities that rely on safety-net services like the CBHHs,” said Piper. “We’re only beginning to make headway. We just can’t afford to go backwards now.”
The CBHHs were established as Minnesota moved away from a system of large regional treatment centers in favor of smaller, more patient-centered, community-based facilities. The hospitals are located in Alexandria, Annandale, Baxter, Bemidji, Fergus Falls and Rochester. Since their inception a decade ago, the CBHHs have treated about 12,000 patients, the vast majority of whom spend far less time in the hospital, are able to return sooner to their homes or to a facility with a less intensive level of care, and are far less likely to be readmitted to the hospital within 30 days of their discharge.