A proposed network of facilities intended to reduce the number of mentally ill people who languish in county jails is facing resistance from mental health advocates, who say Minnesota should focus instead on a statewide expansion of proven intervention programs.
Sen. Barb Goodwin, DFL-Columbia Heights, wants Minnesota to spend $5.5 million to establish three 16-bed "jail diversion hubs" throughout Minnesota. Her measure has the backing of law enforcement agencies, which have complained that a shortage of psychiatric beds often forces them to lock up the mentally ill, where they are less likely to get the care they need.
But Goodwin says lack of support among mental health advocates could jeopardize what she calls badly needed reform.
"It's a pretty damn sad statement when you've got the police and sheriffs more concerned about people's mental health than the advocates are," Goodwin said.
The 38 organizations that make up the statewide Mental Health Legislative Network say Gov. Mark Dayton's proposed budget includes an additional $4.6 million for crisis services over the next two years.
They say the money should be used to establish more mobile teams of mental health professionals in areas where the mentally ill are underserved, including greater Minnesota.
Deploying mobile crisis units can divert people in crisis from hospitalization, harm or encounters with law enforcement.
"We know crisis teams work, and we know crisis beds work," said Sue Abderholden, executive director of the National Alliance on Mental Illness in Minnesota and co-chairwoman of the legislative network. "Do I want to spend $4 million — a substantial amount of money — for a revolving door? No."
A 2013 Star Tribune investigation found that law enforcement agencies around the state were increasingly overwhelmed by the number of people in their jails with mental health problems. In Hennepin County, as many as a third of the inmates on any given day have a history of serious mental illness. Officials said the county spends millions of dollars annually as these people cycle through courts, cellblocks and hospital emergency rooms.
Goodwin's measure, which will get a hearing Monday morning, is modeled after a similar program in Florida.
The facilities would offer short-term stays for diagnosis and immediate treatment for mental health issues. They would serve as a drop-off point for police, who must otherwise lock them up, spend hours in emergency rooms or drive hundreds of miles to find a treatment facility.
Goodwin said the treatment facilities would be funded entirely through grants from the state's general fund, promising that "not a penny" would come from the crisis services budget.
Abderholden said the group supports a $500,000 pilot program in Beltrami County, but doesn't trust that a sustainable mental health program can be built on grants.
"If we want to pilot it, let's pilot it, but not with $4 million, which is a huge amount for the mental health system," she said.
In an exchange last week, Abderbeholden, on behalf of the board, again declined to support Goodwin's proposal.
Goodwin issued a scathing response, saying their decision was based on deliberate misinformation about how the proposal would be paid for.
"Are you simply trying to protect your turf and have no sympathy for the thousands of people in this state who end up incarcerated simply because our mental health system is so profoundly lacking in services and collaboration?" Goodwin wrote.
"This bill should scare no one. It is not replacing anything we currently have, in fact, it is pulling our resources together to better serve people and attempting to add funding and services."
Mark Kuppe, chief executive of Canvas Health, a metrowide organization that provides crisis services to the mentally ill, said it's more important to build on an existing infrastructure to fill gaps in the system, rather than create an entirely new service.
"Having a place like Sen. Goodwin's where you can just drop the client off, I think that's reactive, and I agree we don't want clients in jail," he said. "I just think there are some other kinds of community-based service systems that are not necessarily brick and mortar that need more support. This is more of a financial distraction and a pull from that process."
Hennepin County Judge Jay Quam, long a proponent of a crisis diversion center, said he's a fan of the mobile units, but that they can't handle all situations where sometimes law enforcement assistance is needed. And for law enforcement, he said, "It's often jail, the ER or nothing."
Mahnomen County Sheriff Doug Krier recalls one recent instance where his deputies took one mentally ill man to the emergency room instead of jail, waiting with him for more than 24 hours while medical staff called mental health facilities in Minnesota, Iowa and the Dakotas in search of a bed. Finally, a bed opened in Duluth, and his deputy drove across the state to get him there.
It took more than a day in lost manpower that a jail diversion hub would have prevented, Krier said.
Roberta Opheim, the state ombudsman for mental health and developmental disabilities, recently withdrew her opposition after talking with Goodwin. She does not want mobile crisis units to lose funding, and she wishes the state's community mental health system was so robust that jail diversion centers were unnecessary.
But she acknowledges that at any given time, the proportion of inmates in Minnesota jails with serious mental health problems is higher than it should be.
"I have my version of an 'I Have a Dream' speech of what I would like this to look like, but at the same time, I am excruciatingly aware of the suffering of people picked up by police," she said.
"If we only go with the dreams of the future, what is happening to the suffering today?"