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A new treatment model for the mentally ill

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BAXTER — Gone is the old asylum model where the mentally ill were treated on large state hospital campuses. It was a treatment model that no one seems to miss, at least not in a cross-section of about a half dozen employees who took time out to reflect on the past five years of Baxter’s Community Health Behavioral Hospital.

Situated in a residential neighborhood on Grand Oaks Drive, the 16-bed, state-operated hospital could easily pass for an office building to those who drove past it.

Administrator Dick Slieter, who has headed the unit since it opened in January of 2007, said he thinks the hospital and the transformation in how mental health services are delivered has worked well for patients, staff and neighbors.

“It’s exactly the vision we tried to achieve,” Slieter said. “We’re not there yet, but it’s been a positive experience.”

Marty Bosch, nursing supervisor at the hospital, said the hospital is connected with community providers who can continue to treat patients once they leave the hospital. The first principle is to try to treat the patient close to their home, near their support system. The new system, Bosch said, emphasizes person-centered delivery of care.

Under the old state hospital system, many patients who were in an institution may not have needed to be hospitalized but there were few other health care options for them.

Treatment at the Baxter hospital is for a shorter duration than it was in years past. Officials said the average stay at the community hospital is about three weeks, compared to the typical state hospital stays of about 45 days.

Mary Fraser, a registered nurse at the hospital for the past three years credited the good support of the team for their success.

“It’s challenging but it’s rewarding,” she said of her work.

Kelly Saltness, a human services technician, said the number of patients that had to be dealt with at old state hospital made it difficult to help patients reach their personal goals.

“It’s incredibly rewarding to see patients take control of their lives,” Slieter said.

Slieter said the state had addressed issues concerning access to mental health services and that more admissions are received now than there were under the old system. A number of state-operated Community Behavioral Health Hospitals were established throughout the state. These hospitals, work with an array of other mental health professsionals to find the right treatment for patients.

During the planning stages for the transformation to a new treatment model, Slieter said there wasn’t total clarity regarding how many beds would be needed. After a few years of operation, he said it was found that a greater percentage of patients no longer met the acute care criteria that merited admission to a CBBH. Three years ago, Slieter said it was determined that one-third of those hospitalized in the community hospitals no longer needed acute care or where approaching that point. As a result the mission of some of the hospitals statewide was changed to help those with sub-acute care needs.

Baxter Police Chief Jim Exsted said that while certain neighborhood residents had initially expressed reservations about the hospital’s location near their homes those fears seem to have dissipated.

“They support and trust their hospital,” he said.

The state, the chief said, has done a good job educating people about the hospital through a neighborhood advisory council. He said his department might receive about five calls a year to respond to the hospital, and some of those are to help with a medical situation rather than to help deal with an unruly patient.

“We’re very fortunate in Baxter,” Exsted said. “We have very, very few calls here.”

Exsted serves on the Baxter hospital’s governance board.

Bosch said he thinks the general public’s understanding of mental health has increased.

“Now it’s clear to people ... That’s your brother and your cousin and your neighbor,” Bosch said.

Slieter said mental illness is a biological brain disorder and people are showing an increasing willingness to discuss mental health issues.

“The stigma associated with mental illness has gone on way too long,” Slieter said. “We need, as a community, to embrace that knowledge (about mental illness). I think we’ve improved but we have a long way to go.”

MIKE O’ROURKE may be reached at or 855-5860.

Mike O'Rourke
Mike O'Rourke began his career at the Brainerd Dispatch in 1978 as a general assignment reporter. He was named city editor in 1981 and associate editor in 1999. He covers politics and writes features and editorials.
(218) 855-5860