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A mental health overhaul is in the works in Region 5

Wadena County is among a number of area counties focused on loosening the deadly grip mental illness has on the area.

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Action steps are taking place to fulfill some of the areas of need identified by a Greater State of Mind gathering in 2021.
Image contributed by Region 5+ Mental Health Initiative
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WADENA — A move to more proactive programming in Wadena County hopes to turn the tide of mental health problems plaguing the region.

In a recent conversation with Wadena County Commissioners on August 16, Human Services director Jennifer Westrum brought forth several agenda items all bent on being proactive rather than reactive to situations that keep arising with mental health.

Top of the list was the recent decision to hire a mental health coordinator who will be working in Wadena, Crow Wing, Morrison and Todd counties to help identify initiatives to pull the area out of this crisis. Based upon the 2021 Greater State of Mind Project brought together by the Region 5+ Mental Health Initiative , this is a much needed position which will focus on expanding the availability of mental health resources for residents. The coordinator will be an employee of Sourcewell and will begin in late 2022 or early 2023.

Life skills training

Another is the work being done by Wadena County Human Service staff Madi Lausten and Carlie Reading for at-risk youth in the county. They secured funding for the program through the Family Services Collaborative (FSP) in order to offer a five-week program focused on life skills in youth. There were nine youth from throughout the county who participated in the initial programming and about five that were able to attend regularly. Lausten said some of that had to do with transportation.
The LIFE 101 Program provides education and support to at-risk youth while simultaneously utilizing local resources and connecting the 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 to promote success in adulthood and prepare them for life’s challenges, thus reducing the likelihood of youth encountering difficulties in the future. The hope is that youth will have a decreased need to access “rescue services” in the future as well by learning how to more effectively navigate the adult world.

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Jennifer Westrum, Wadena County Human Services director. Submitted photo

“Wadena County Human Services Child Protection and Children’s Mental Health teams have noticed 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 poses a transportation and logistical barrier for many of the families we serve. By hosting an ILS program in our county, we are hoping to reach more youth who might not otherwise have the same opportunities to learn independent living skills that will serve them into adulthood.” The goal of the LIFE 101 program is to teach independent living skills to underserved youth that they can take into adulthood. Within this overarching goal, the program aims to assist youth in learning how to build healthy relationships, live 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.
When the need for this type of programming was questioned, Wadena County Attorney Kyra Ladd commented that the real cost to the county is in not doing these types of programs.
“I think it's a really good program,” Ladd said. She said that this provides a service to keep youth out of trouble and potentially out of the adult criminal justice system.

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Staff shortages, lack of beds

One area that does not have an immediate remedy is the matter of the county paying for use of a bed at a Child and Adolescent Behavioral Health Hospital when the patient does not meet criteria (DNMC) to have state funding pay for their stay there. Normally the individual would be moved out to a site requiring less acute services at a far lower cost. But staffing shortages have limited availability of beds.

“There just are no beds to discharge this child too,” Westrum said.

While progress is not instant, director Jennifer Westrum said all of their units are working on changes to provide the best service.

In this situation, the county has run into problems where costs start adding up very quickly when the bed is costing $2,000-plus per day for an individual to stay there. Westrum indicated that several local staff and one from the cities took on a national search of beds in 35 states that could take this individual, keeping in mind that they have to be visited by county staff on a regular basis, so they cannot be too far out of reach or it may create another undue cost. No bed could be found.

Prior to the pandemic, discharging residents from one level of care to another was difficult. Since the onset of the pandemic, it has become nearly impossible to find an appropriate discharge placement. This is caused by either staffing shortages or staffing being out due to illness.

In these cases, the patient no longer needs the same acute level of care that put them into the bed, yet they still need a place to go prior to being discharged home.

“I believe we have done everything in our power to get them into a lower level of care,” Westrum said. “Once moved into a group home setting the county would no longer be paying for this.”

At the time of the meeting the individual had been receiving care for 20 days at a rate of about $2,400 a day. That’s a cost billed to Wadena County, and a cost no one budgets for or can plan for.
What would help to reduce this type of circumstance from being needed, leaders say, is more work done in the home of the mentally ill.

Reducing out-of-home placements

Reducing out-of-home placements can start with in-home therapy, according to Westrum as she outlined a plan to request matching dollars from Sourcewell to help pay a portion of the cost to bring Nexus Kindred Foster Care training to help families have the skills to help their children with intensive mental health needs stay in the home rather than being sent out of home. This is a collaboration between Region 5 county partners. It’s called Collaborative Intensive Bridging Service (CIBS) and has a goal of further reducing out of home placements.

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Westrum also requested a reclassification of a Human Services staff member from a child protection worker to an in-home family therapist. This would allow the county to assign a therapist to a family or child to prevent removing a child from a home while providing the child and family the resources they need for a more positive outcome. The reclassification would result in a savings to the county by way of reducing services with an outside provider.

More importantly, every dollar spent in reducing the need for these services down the road results in a $4 return, according to Westrum. More importantly still, it’s not only intended to be an overall cost savings, it’s intended to reduce the number of children and families caught in a cycle of needing human services intervention.

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