Staff photo by Kevin Sweeney State Sen. Gary Dahms (R-Redwood Falls) (left) and State Rep. Paul Torkelson (R-Hanska) (second from left) discuss mental health issues with a Brwon County partnership of service providers on Monday.

NEW ULM — A partnership of health care, county service and law enforcement providers presented their concerns about mental health needs in the community to two local legislators on Monday, during a discussion at New Ulm Medical Center.

The partnership has been meeting to discuss mental health and addiction needs in Brown County since a hospital survey of community needs showed a growing need for mental health services and facilities, the group told Sen. Gary Dahms (R-16) and Rep. Paul Torkelson (R-16B). The group outlined how mental health issues has been affecting them, what they have been doing collaboratively to meet those needs and what further steps need to be taken by state government.

Jen Maurer from NUMC and Julie Hogan of Brown County Family Services talked about the mental health and wellness action team the NUMC and county have formed, trying to change the negative images about mental illness that often prevents people who need help from seeking it for years. The group started Health and Happiness programs to get people focused on being grateful for things in their lives; to take part in random acts of kindness and to help manage their stress.

In the schools, the group has started a “Teach to Chill” program, in which counselors teach students how to deal with stress. District 88 has hired a counselor who works full time with students on mental health issues, said ISD 88 Superintendent Jeff Bertrang.

Funding Needed

Hogan said in some ways the state’s mental health system is broken. A lot of mentally ill are being treated as criminals and may wind up being jailed due to a shortage of services. There is a need for funding to create more spaces and hire more staff for these people, she said.

The providers are doing what they can. Allina Health has provided some funding to help people get into residential treatment programs while they wait for their insurance coverage to kick in.

Providers are working on the way they provide mental health services to people with no insurance or coverage. A program starting Jan. 1 will be referring people with no insurance or high deductible insurance that makes treatment unaffordable to a group of provides in the county who will provide treatment.

Staffing is also a problem. Some programs have had to shut down or turn people away due to lack of psychiatric staff. Rapid turnover in providers is also problem, with programs having to start over again with new people.

Law Enforcement

Local law enforcement staff and emergency room staff talked about how the mental health patient volume has grown, along with the expectations on them and regulations they must contend with. expectations have grown, requirements have grown.

Mental health patients coming in to the emergency room have to be assessed and referred to residential programs, if needed. Once the patient is recommended for treatment, the issue becomes where to put them. Residential programs are limited by a state moratorium on the number of beds, and the types of facilities that can be operated. Brown County Chief Deputy Jason Seidl said that in the past, most patients could be taken to the St. Peter Security Hospital, but since the state has moved away from institutionalizing them, it has become harder to find places for them to get treatment. Some facilities won’t accept patients with violent or aggressive tendencies, or chemical dependency issues. Some won’t take children under 12. Sometimes a patient may sit for four or five days in the emergency room until a place can be found, though most are placed within 24 hours.

New Ulm Police Chief Dave Borchert talked about the training law enforcement officers are now receiving for dealing with mentally ill people they may encounter. The city is working with the county and with Allina Security to collaborate on training.

Borchert said law enforcement encounters more than the average share of mentally ill people. While statistics show one in five people may have mental health issues, law enforcement sees those who are in crisis.

Seidl said that the local jail is the place of last resort for patients in need of services. The jail has added two padded cells, with extra camera and staff to watch over them. It’s a short-term solution to finding them a placement for treatment.

Jennifer Brehmer, director of patient care at NUMC, and Mary Shupe, inpatient mental health manager at NUMC, talked about the increased demand on the residential mental health program at the hospital. The ward is usually full, and the average stay has grown from four to eight days. Keeping enough providers on staff is a challenge, and the hospital has started to use telemedicine visits between patients and psychiatric service providers elsewhere in the Allina system. The hospital is adding a nurse practitioner in January who will be able to prescribe medications for patients. Members of the partnership also talked about financial concerns, especially the charges the county must pay for patients sent to other communities for treatment, after their providers decide they no longer need treatment, but before they can be released. The state charges $1,200 to $1,400 a day to the country for patients who no longer being treated, but are still in the care of the hospital or agency. The county is also responsible for transporting the patients from the facility to their community, and those transportation services are not always user friendly. Other companies that could provide the service more efficiently often have difficulty getting certification.

Dahms and Torkelson praised the group for their collaboration and thanked them for the opportunity to learn.

“You are taking an issue and doing the best you can,” said Dahms.

Dahms said there is no question the Legislature doesn’t understand issue of the shortage of beds, but it is starting to learn. Often, it isn’t until the state gets to the point of allocating funds that it gets fully educated.

“There’s an awful lot of work to be done, but I think the realization growing that there is a problem.”

He also lamented that some measures that would have been helpful were caught up in the major omnibus bill last year that was vetoed. Dahms said it is apparent that giant omnibus bills don’t work very well, but the system is likely to be revised.

Torkelson said identifying issues at the local level helps legislators to learn at the state level. He said keeping mentally ill people out of jail is a good goal, but the state has to figure out how how to deal with them.

“We will continue to head in that direction,” he said.

He said that as a member of the Transportation Finance committee in the House, he will look into what can be done to make the transportation of patients more efficient.