Mental health stakeholders identify next steps for N.D.

Dec. 27--Some of the shadows enveloping mental illness and its public discussion are disappearing, but experts say more needs to be done to erase stigmas surrounding it and improve access to services.

In order to move forward, more funding is essential, mental health officials say.

"If we can get some support behind us -- financially, of course, with the Legislature meeting -- then we can strengthen our mental health system," said Debra Johnson, CEO of Prairie Harvest Mental Health in Grand Forks. "It needs to happen. We just don't have enough funding."

Although funding to expand mental health programs and services in North Dakota has increased in the past decade, a recent report released by a consulting firm says the state's mental health and substance abuse system is in peril. The report, prepared for the state by Schulte Consulting, attributes part of the problem to a lack of funding, which is creating service shortages.

Although Gov. Jack Dalrymple's budget for the 2015-2017 biennium includes a 13.2 percent increase for mental health services, it won't be an instant fix to the state's problems, according to Sen. Judy Lee, R-Fargo. Lee serves on the Legislature's interim Human Services Committee, which recommended the increase in funding.

The $233.5 million set aside for mental health services in the next biennium is a step toward trying to improve services in the state, she said.

"If we're able to improve services in general, then all the specific groups (of people) could benefit," Lee said.

Workforce needs

Bills coming out of the interim Human Services Committee include requests for funding for mental health services internship programs and stipends for mentors overseeing interns to encourage workers to stay in North Dakota.

One area of concern highlighted by the Schulte report is the state's western half. It's predicted to be a challenge in the coming years as high cost of living and a housing shortage make it hard to hire enough mental health professionals to meet the region's demands.

Demand for services has increased with the number of workers arriving in the area from out of the state that may have no family or form of support, according to North Dakota Human Services staff.

While workforce needs may be dire in the west, the remainder of the state needs more professionals and services as well.

"We have a really pressing workforce issue," Lee said. "You can't take care of people if you can't provide them with professional services."

Nearly all of North Dakota's counties are considered health professional shortage areas when it comes to mental health workers. The Health Services and Resources Administration defines a shortage area as having more than 30,000 people for every psychiatrist.

Expanding services

In addition to increasing professional workforce numbers, mental health experts say expanding services also is vital.

One option may be increasing the use of telemedicine, which allows professionals to converse with patients via video on various devices. This technology makes it possible for patients to stay at home and avoid the stigma that still surrounds going to a mental health center, according to Lee.

"For some people there's still a stigma involved, especially in small communities, you don't want to go into a mental health facilities because someone knows you're going into a mental health facility," she said. "We still have some of that prevailing thought process, and we're trying to make it easier for people to get the kind of help they need."

Partnerships between public and private partnerships do exist and that collaboration has played a role in expanding the availability of services and treatments, according to Johnson.

Restructuring services also may be key to meeting the demand for mental health services.

Nationwide, Johnson said service providers are switching to a recovery-focused model, which gives patients more say in their recovery and allows the process to be more attuned to their needs.

Other recommendations from the interim committee and a state council called the Behavioral Health Stakeholders Group include expanding peer support systems, establishing four mental health assessment centers and identifying unmet mental health needs for adults and children.

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