Rural Minnesota mental health overhaul in the works – Duluth News Tribune

WADENA, Minn. — A shift to more proactive programming is expected to turn the tide of mental health problems plaguing several rural counties in central Minnesota.

Wadena County Human Services Director Jennifer Westrum proposed several items to the Wadena County Commissioners on Aug. 16, all looking to be proactive rather than reactive to mental health situations that continue to arise.

High on the list was the recent decision to hire a mental health coordinator to work in Wadena, Crow Wing, Morrison and Todd counties to help identify initiatives to lead the area out of this crisis. Based on the Greater State of Mind 2021 project brought together by the Region 5+ Mental Health Initiative, this is an in-demand position that will focus on expanding access to mental health resources for residents. The coordinator will be a Sourcewell employee and will start in late 2022 or early 2023.

Another is the work done by Wadena County Human Rights Officers Maddie Lausten and Carly Redding for at-risk youth in the county. They secured funding for the program through the Family Services Collaborative to offer a five-week program focused on youth life skills. There were nine youth from across the county who participated in the initial programming and about five who were able to attend regularly. Lausten said some of that has to do with transportation.

The LIFE 101 program provides education and support to at-risk youth while utilizing local resources and connecting youth with community partners. The LIFE 101 program works to help youth develop independent living skills, which is an evidence-based intervention supported by state and local child welfare initiatives. Providing youth with independent living skills helps promote success in adulthood and prepares them for life’s challenges, thereby reducing the likelihood that youth will experience difficulties in the future. The hope is that young people will have a reduced need to access “rescue services” in the future as they learn how to navigate the adult world more effectively.

Jennifer Westrum, Wadena County Director of Human Services. Photo sent

“The Wadena County Child Protection and Child Mental Health teams have identified a need for a local Independent Living Skills (ILS) program for the teenage clients we serve in our area,” according to documents shared by Westrum. “Currently, the closest available ILS program is hosted in Brainerd, Minnesota, which presents a transportation and logistical barrier for many of the families we serve. By hosting an ILS program in our county, we hope to reach more youth who might not otherwise have the same opportunities to learn independent living skills that will serve them well in adulthood.”

The program aims to help youth learn how to build healthy relationships, lead a healthy lifestyle, learn to keep themselves safe and successfully navigate the nuances of the adult world. This program has funding for three more rounds and can take up to 16 per round.

Lack of staff, lack of beds

One area that does not have an immediate resolution is the issue of the county paying for a bed at a child and adolescent behavioral health hospital when the patient does not meet the criteria to pay state funding for the stay there. Usually, the person will be transferred to a place that requires less urgent services at a much lower cost. But the shortage of staff leads to a limited number of beds.

“There’s just no discharge beds for that kid either,” Westrum said.

In this situation, the county has run into problems where costs start to add up very quickly when a bed costs more than $2,000 per day per person to stay there. Westrum pointed out that several local officials and one of the cities have launched a national search for beds in 35 states that could accept this person, given that they must be visited regularly by county officials, so they cannot be too far out of reach or may create another unnecessary expense. No bed could be found.

Before the pandemic, discharging residents from one level of care to another was difficult. Since the beginning of the pandemic, it has become almost impossible to find a suitable place to discharge. This is due to either staff shortages or staff absences due to illness.

In these cases, the patient no longer needs the same level of acute care that put them in bed, but still needs a place to go before being discharged home.

“I believe we’ve done everything in our power to put them at a lower level of care,” Westrum said. “Once moved to a group home, the county will no longer pay for it.”

At the time of the encounter, the individual was receiving care for 20 days at a rate of about $2,400 per day. This is an expense charged to Wadena County and one that no one anticipates or can plan for.
What would help reduce the need for these types of circumstances, leaders say, is more in-home work for the mentally ill.

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