Opinion editor’s note: This article was submitted by the leaders of several organizations involved in mental health in Minnesota. They are listed below.
Just a few weeks ago, we were all working together on bills that would address the unmet needs of children and adults with mental illnesses and their families. Since it’s not a budget year, the changes were primarily focused on policies and with small budget asks. They included items such as changes to the commitment act, expanding intensive services to children with serious mental illnesses, eliminating holes in the continuum and bonding dollars for affordable housing.
We all advocate together every year to improve policies and increase funding for our mental health system. A system that isn’t broken, but is fragile, underfunded, understaffed, and difficult to navigate. A system that does not provide the early or intensive intervention that is desperately needed, and that has long wait times and results in frequent boarding in ERs.
And then COVID-19 hit. The mental health system in Minnesota and across the country is now on the verge of collapsing.
Many people who live with mental illnesses are confined to their homes or lost their jobs. They have also lost structure to their lives, connection to others and a paycheck — possibly health insurance. Their symptoms will likely re-emerge and may reach a crisis point. Families who have children with serious mental illnesses who were in more segregated special education settings are alone, lacking supports, with children who have very high needs. We are already seeing these families reach the crisis point. But going to the ER is not a good option for anyone.
As the mental health of our entire population worsens due to the uncertainties, fear and loss of connection, those who already live with a mental illness are impacted even more. The demands for our mental health system will only increase in the weeks ahead.
The symptoms of mental illnesses often result in isolation, pulling back from others, which is why so much of mental health treatment is face-to-face. Therapy, groups, drop-in centers, in-home supports — all are done in-person in order to connect to the individual, to see in real time how they are feeling and responding. Services see how children are interacting in the classroom, check to see that adults have food in their home, teach people skills to deal with their symptoms and provide the human interaction that is so needed.
And now that is lost. While public and private insurance has moved to paying for telehealth, including phones, that is for therapy and not for in-home services. Thousands of people do not have computers, laptops, smartphones — even regular phones. Thousands don’t have access to the internet. Isolation is increasing.
This all comes at a time when our health care, county and social services partners are asking community mental health providers to increase capacity for care as the COVID-19 crisis surges, knowing that mental health crises across communities will increase in the coming weeks. Mental health and substance use disorder services are critical to maintaining overall health — fear-induced anxiety and stress reduces immune systems. More people will become sick if we do not meet their mental health needs. Our community mental health agencies need to be able to immediately preserve access to services and avoid unnecessary hospitalization, when our hospitals are already so strapped, and we do not want people going to ERs.
Mental health agencies are continuing to provide services through alternative modes to support people with mental illnesses and the community, while not knowing if they will be paid. Already lack of payment for services and the inability to provide in-person services and supports has led to large layoffs in community mental health agencies, small and large. Even mental health crisis teams are laying off large percentages of their staff.
The state’s community mental and chemical health agencies need immediate emergency financial relief and regulatory flexibility to provide critical mental health services to the people who need them.
It’s time to turn our attention to keeping these doors open, the staff employed, and the technology delivered to people who have no access. We could barely keep our mental health system afloat before the COVID-19 crisis. Throw it a lifeline now before it cannot be revived.
The signatories to this article are Sue Abderholden, executive director, NAMI Minnesota; Kirsten Anderson, executive director, Aspire Minnesota; Jinny Palen, executive director, Minnesota Association of Community Mental Health Programs; Deborah Saxhaug, executive director, Minnesota Association for Children’s Mental Health; Willie Garrett, president, Minnesota Psychological Association; Dr. Sheila Specker, president, Minnesota Psychiatric Society; and Shannah Mulvihill, executive director, Mental Health Minnesota.