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Minn. mental health system gets $48 million in new funding, defying national trend

Star Tribune (Minneapolis, MN) - 5/31/2016

May 31--For the second consecutive year, Minnesota legislators approved tens of millions of dollars in new funding for mental health care, defying a national trend of state cuts to such services.

In a session derided for inaction and partisan squabbling, lawmakers once again came together on a bipartisan basis to approve proposals aimed at easing chronic bottlenecks in the state-funded mental health system and increasing the availability of crisis services in the community. All told, the 2016 Legislature approved about $48 million in new investments through next June -- far less than sought by Gov. Mark Dayton, but still seen as a considerable victory given the Legislature's 11th-hour failure to pass a monumental bonding bill.

Yet these gains were overshadowed by the absence of new money for the troubled Minnesota Security Hospital in St. Peter, which houses about 370 people with serious mental illnesses. The hospital has struggled to contain a wave of assaults against staff members, and the "conditional" status of its license was extended in 2014 after a patient was stomped to death in his room by another patient -- a killing that state investigators later blamed on poor supervision.

Dayton made a proposed $90 million overhaul of the Security Hospital a key piece of this spring's legislative agenda -- calling the investments "imperative" after "decades of neglect" at state-run mental health facilities. His package included enough funding to add 335 employees at the Security Hospital over the next three years; that would have brought staffing in line with similar treatment facilities in other states. The proposal faltered amid legislators' suspicions of past money going misspent, and the Security Hospital became a casualty of a short and dysfunctional session.

Human Services Commissioner Emily Johnson Piper called the lack of new funding for the Security Hospital "extremely disappointing" in a statement last week. "The Security Hospital has urgent needs, particularly investment to address the unsafe ratios of patients to staff, and ongoing safety and care challenges the staff and patients there face on a daily basis," she said.

Those concerns were echoed by hospital workers and their representatives with the labor union AFSCME, which escalated a "Safe Staffing" campaign this year to highlight violence at the hospital. The union brought workers to the State Capitol to testify about workplace violence, and posted hundreds of graphic photos of worker injuries on Facebook, as well as video testimonials from employees who were victims of assault.

Staff members at the Security Hospital reported 100 injuries from assaults last year, up from 71 in 2014 and just 60 in 2013, according to state Occupational Safety and Health records.

Kaija McMillen, 25, a security counselor at the Security Hospital, is still recovering from a traumatic brain injury that she suffered last July when a teenage patient at the hospital grabbed her by the hair, slammed her head against a brick wall three times, and kneed her in the back of the skull -- causing her to lose consciousness. McMillen said that the patient had assaulted her twice before but that hospital administrators had declined her request to move to a safer unit, citing a lack of staff.

McMillen, of Le Center, said that she had wanted to testify at the Capitol this spring about violence at the Security Hospital, but that she had not recovered enough from her injury to speak in public or drive a car.

"I don't know how [legislators] can sleep at night," McMillen said. "Essentially, legislators are saying it's OK and acceptable to go to work and expect to suffer life-changing injuries."

While calls for improvements at the Security Hospital eventually got buried amid competing interests, a bevy of other mental health programs received sizable new investments. This includes nearly $20 million to increase staffing at Minnesota's seven, 16-bed community behavioral health hospitals -- so they can operate at full capacity -- and the creation of a new program for mentally ill patients awaiting criminal trials, designed to free up more beds.

Legislation also was passed that would, for the first time, fund the development of community health clinics that would treat both complex mental health conditions and substance abuse. In addition, there was more funding for school-based mental health and expanded access to crisis housing.

The investments built on major gains made during the 2015 session, and continue to set Minnesota apart. While legislators and advocates have bemoaned the nation's "broken" mental health system, only Minnesota and 10 other states have increased mental health funding each year between 2013 and 2015, according to the National Alliance on Mental Illness (NAMI).

"We have more people focused on this issue than ever before," said Sue Abderholden, executive director of NAMI Minnesota. "Other states are cutting, and we continue to invest. People at all levels understand the importance of improving access to mental health."

Twitter: @chrisserres

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