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State asks for mental health suggestions

Free Press (Mankato, MN) - 9/2/2014

Aug. 30--NORTH MANKATO -- The 100 or so professionals who gathered at South Central College on Friday generally agreed on the basic flaws with how mental health care is delivered.

"From the provider perspective, access is the glaring issue," said Becky Ness, a physician's assistant at the Mayo Clinic Health System in Mankato.

That is especially true for those on public insurance, as some doctors will only see a limited number of patients on Medical Assistance. The root cause of this issue is that doctors generally get paid less for mental ailments than physical ones, she said.

And even for those with top-shelf insurance, wait times can be long, she said.

Problems with access extend outside of the clinic. It can be difficult to find transportation, they said, and affordable housing.

The participants at the meeting, one in a series organized by the Minnesota Department of Human Services, also agreed on some of this area's strengths when it comes to mental health.

The Mankato crisis center was noted at least three times, especially for its ability to take patients without a referral. Drug courts and educational resources also were cited as working well here.

And county case managers were seen as effective bulwarks against psychiatric hospitalizations.

But recent budget cuts that limited who is eligible to receive a case worker has resulted in a step backward. State Sen. Kathy Sheran, DFL-Mankato, said changing that would be expensive -- the state pays half of case manager costs -- but is worth exploring.

The alternative, Sheran said studies have shown, would be for the public to spend even more on expensive hospitalizations.

A similar refrain was the lack of preventive services. The alternative is to wait for a crisis then end services when the immediate crisis ends.

In addition to the flaws and successes of how mental health is delivered in south-central Minnesota, the state also asked what it should focus on. The department's biggest priority ought to be affordable housing, according to the group, though there was no lack of suggestions.

Add hospital beds for people in crisis. Address the shortage of providers and help them collaborate. Encourage more consumers to be self-advocates. Indeed, there appeared to be very few actual mental health consumers at the meeting.

Ness, the Mayo physicians assistant, suggested the state could help relieve the shortage of practitioners without hiring anyone. For example, physicians assistants can't bill Medical Assistance unless their patient is admitted to a health care facility.

Removing some of these restrictions would add to the pool of people who can bill for -- and thus provide -- mental health care, she said.

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