Crow Wing County Board: Northern Pines seeks support for psychosis treatment grant

A letter of need sought for a state grant proposal for mental health services took two tries to receive approval at the Crow Wing County Board meeting April 12.

Kris Blake of the Northern Pines Mental Health Center and Kara Griffin, division manager in Crow Wing County Community Services, presented the request to the board. The requested letter of need would accompany a proposal to the Minnesota Department of Human Services on behalf of Northern Pines to administer a program expanding services for adolescents and young adults experiencing a first episode of psychosis.

The request for proposals from the state is seeking coordinated care teams to assist in early intervention in psychosis and severe mental illness. Blake said the Youth ACT program the treatment center currently administers would be a good fit for taking on this additional effort.

"We've already been treating these people, and this grant would also allow us the finances to seek further consultation and training in the state of Minnesota, so we can integrate this into our community," Blake said.

Youth ACT, which stands for Assertive Community Treatment, is a team approach to mental health care for those age 16-20 with a serious mental illness diagnosis. The team includes a psychiatric provider, mental health professionals, a peer recovery specialist and a rehabilitation and educational specialist. Blake said the program is different than traditional approaches, because rather than treating the symptoms, it helps young people "become functional members of the community."

Griffin said if Northern Pines were selected it would fill a gap concerning what is available for mental health care in the area. The $500,000 grant would allow the treatment center to expand its services by 25-30 people. Research shows, Blake said, that early intervention can prevent repeated use of crisis services and hospitalizations of these patients.

Commissioner Rachel Reabe Nystrom said she thought it was a "wonderful idea" to intervene as quickly as possible with patients experiencing first episodes of psychosis. She asked if patients needed hospitalization, however, where would they go in light of the apparent full capacity of the Community Behavioral Health Hospital in Baxter.

"That's a huge deficiency in our area, in the state of Minnesota," Blake said.

Griffin said although the program would not directly impact this issue, it could have long-term effects.

"This would potentially impact the long term in those individuals who continue to struggle and then end up exhausting the crisis bed or other resources," Griffin said.

Commissioner Paul Koering, who often expresses a dislike for the county board providing letters of need, asked the presenters whether any other organization in the community would seek this grant.

"I just have a problem with us lending support to a private entity that is not a governmental entity," Koering said.

Griffin said no others approached community services about the request for proposals.

Commissioner Paul Thiede, who requested the letter of need be removed from the consent agenda for further discussion, asked for clarification on the capacity of the Community Behavioral Health Hospital.

Griffin said they have fewer patients than what the license allows due to a shortage of trained staff.

"Because we're not fully staffed, we're saying we're at capacity," Thiede said. "Sounds to me like we're understaffed. ... Now once again, we're now bringing a new program in to take care of a deficiency in the design of the delivery system."

County Administrator Tim Houle said Thiede was seizing on a big issue by broaching the state's role in mental health services.

"We see the impacts of the state's deficiency in that regard in the county jail," Houle said. "We've heard from the jail administrator many, many times about how the state's deficiency to provide a sort of safety net ends up criminalizing a lot of mental health issues. The failure of the state to adequately fund staffing for the CBHH is another symptom of that large problem. So I wish that the state would step forward and do a better job funding mental health services within our community. I think we all share in that wish. ... You push on the bubble in one place and it comes somewhere else."

Thiede thanked Houle for making his "case in spades" for requesting additional discussion on the consent agenda item.

"That's exactly why I wanted to have it come forward," Thiede said. "We're going at one problem that's much huger than this."

Nystrom made a motion to provide the letter of need, but the motion died for lack of a second. Commissioner Rosemary Franzen said she intended to abstain from voting on the matter. Franzen serves on the treatment center's board.

About 20 minutes later, after discussion of an unrelated item, Koering said after reflection, he felt the board should show its support for mental health services in the community. Koering made a motion to support the letter after reiterating his stance on the letters of need in general. Nystrom seconded his motion and it passed 4-0.

CHELSEY PERKINS may be reached at 218-855-5874 or chelsey.perkins@brainerddispatch.com . Follow on Twitter at www.twitter.com/DispatchChelsey .