Minnesotans who struggle with a combination of mental illnesses and substance abuse disorders will soon receive faster, more integrated care in their communities without having to navigate a Byzantine system of local health agencies and clinics.
Under a pilot program announced Thursday and set to begin in July, six community clinics across the state will offer therapies for people suffering from multiple disorders, including chemical addictions and serious mental illnesses. The goal is to bring a range of such services under the umbrella of these clinics, reducing the burden on patients and increasing the likelihood of follow-up visits and consistent care, state officials said.
"This is such a radically important step," said Claire Wilson, assistant commissioner of community supports at the state Department of Human Services. "We will have coordinated, 'one-stop shop' care centered on community health centers, which are the most immersed in providing this type of care."
Minnesota is one of just eight states selected to experiment with the coordinated model under a two-year federal pilot program.
Typically, patients suffering from complex mental and chemical health problems must navigate a maze of primary care clinics, treatment plans and eligibility requirements to get help. For instance, patients are often discharged from hospital psychiatric wards with little or no information on how to obtain outpatient care in the community. A state task force established by Gov. Mark Dayton concluded in a report last year that this fragmented system often impedes people from getting crucial mental health services.
The system was not supposed to work this way. In 1963, when President John Kennedy signed the landmark Community Mental Health Act, he envisioned a broad network of clinics across the nation that would serve as an alternative to large institutions by providing "comprehensive" care in the community, from inpatient treatment to community education. However, these clinics were never adequately funded; and today, many mental health patients must go to different providers for mental health, substance use and physical illnesses.
"This takes us back to what Kennedy originally envisioned," said Sue Abderholden, executive director of the National Alliance on Mental Illness (NAMI) of Minnesota. "It's a much fairer way to go."
The bundle of services covered include chemical dependency treatment, primary care screening and trauma-focused therapy for children, and mobile mental-health crisis response, among others. Case managers will also be available to help patients obtain and coordinate services.
Clinics participating in the pilot will be reimbursed by the state-federal Medicaid program at a rate closer to the actual cost of providing care, which should provide more individualized therapy and form deeper relationships with patients, officials said. Patients who are too ill or depressed to leave the home, for instance, could qualify for house visits from a psychotherapist, a service not normally provided by health clinics.
"With this program, we can eliminate the silos and tailor the care plan to an individual's needs," said Glenn Anderson, executive director of Northern Pines Mental Health Center in Brainerd, one of the six clinics selected for the pilot program. "And we're not going to go broke doing it."