During the first year of the pandemic, there was a 25% increase in the prevalence of anxiety and depression worldwide, according to the World Health Organization. Minnesota mental health providers are seeing the increase in demand firsthand.
There are about 10,000 people across the state who are on waiting lists to get mental health help right now. Minnesota Association of Community Mental Health Programs Executive Director Jin Lee Palen shared that statistic with the caveat that the number may actually be higher.
“This is 10,000 folks on waiting list reported from 20 agencies,” said Palen. “That’s only 20 agencies from our 34-member association. We know that we are not the only providers of mental health services in the state and so if we think about all of the other agencies that are not represented through this survey and all of the waiting lists that people are on for those agencies, I think that number is probably quite a bit larger.”
She explained the waits can range from 60 to 180 days, which creates a hardship for families and individuals seeking care. It can also create a burden for other health care providers.
“We may see a lot of these folks end up in emergency departments, or end up in in-patient hospital care,” said Palen. “Without having these community services available for treatment and ongoing care, the acuity level and the crisis level of some of these mental health conditions might end up to the point where there’s no other option.”
The increase in demand comes at a time when community mental health programs are already hurting. Palen explained the pandemic has exacerbated workforce shortages.
Organizations are also struggling financially. The community-based programs they represent rely on Medicaid reimbursements and grants for funding, according to Palen.
“We were already in a space where we had services that were being provided not at a sustainable reimbursement or sustainable investment rate,” said Palen. “We already had a workforce shortage that we knew coming into the pandemic. For years now, I think we’ve been watching that and we’ve had fewer students coming in the fields of psychology and psychiatry than folks we anticipated would be retiring.”
She told us they were trying to work towards long-term fixes but two years into the pandemic, “I think we’re noticing now that those gaps have just been have exponentially have been growing exponentially.”
Palen and other mental health providers and organizations are urgent state lawmakers to pass emergency funding. A bill has been introduced in the Minnesota House of Representatives, which would provide $62 million in American Rescue Plan funding in 2023 for community mental health organizations.
To be eligible, organizations would have to agree to use at least 90% of the funding for hiring and retention bonuses, increase employee benefits, and provide additional training and supervision. Community mental health programs are defined within the legislation as providing day treatment programs for children and adults, with at least 30% of their clients being uninsured or enrolled in medical assistance or MinnesotaCare. It is not designed for those providing hospital inpatient or outpatient services.
More than half a dozen organizations and programs have sent letters of support to House lawmakers.
“With the impacts of omicron variant, underinvestment in our community-based mental health continuum, and the resulting impact of the great resignation, we are facing a crisis beyond definition,” said Kirsten Anderson, the executive director of Aspire Minnesota — a group that provides resources and advocacy for kids and families.
She and others who support the bill spoke during a virtual House Behavioral Health Policy Division meeting on Wednesday.
“I wish you could hear the desperation our intake team hears every day as they take calls and share with families that our waiting lists are up to 12 months long,” said Jule Sjordal, the CEO of St. David’s Center for Child and Family Development .
While House lawmakers unanimously voted to move the bill forward to the Human Services Finance and Policy Committee, Rep. Keith Franke, R-St. Paul Park, raised questions about the future.
“I know we’re filling the gaps right now… but where do we go from here once we get to that point, once we fill these positions?” he asked. “Do you foresee your organizations being able to continue to function at that level once those payments drop off? Will we have to come back reassess rate-paying? Where do we go from here after this?”
In response, Sjordal and Anderson encouraged lawmakers to take action on reimbursements.
“We’ve been squeezed for years and we’ve hit a breaking point,” said Sjordal. “We need the rates to cover the services so it is a pretty simple solution and I would urge legislators to act on rate adjustments for Medicaid.”
The bill doesn’t yet have a Senate companion bill.
Palen is hopeful the legislation will move forward.
“We want to be able to think about how are we innovating, how are we growing programs, how are we getting more folks into more services and continuing to evolve our system and grow it but right now what we’re focused on is saying how do we keep programs from having to close their doors,” said Palen. “I think we have some real opportunities to turn the ship around in our mental health system.”
If you are in immediate need of mental health services, visit fasttrackermn.org. You can also find your county’s specific mobile mental health crisis team here.
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