A new report released by the Mat Su Health Foundation indicates that behavioral health services in the Matanuska Susitna Borough are woefully inadequate. The report, the first of three, suggests that residents are not accessing care until they are in a crisis situation.
The report, issued in late January, presents some disturbing statistics. It focuses on a crisis response system that falls far short of meeting current needs. Elizabeth Ripley is executive director of the Mat Su Health Foundation, which operates Mat Su Regional Medical Center. Ripley says the hospital is doing double duty:
“Even thought is doesn’t offer psychiatric services, it is the number one purveyor of mental health care in our community.”]
Ripley says the hospital’s emergency room is handling thousands –2300 cases alone in 2013 — of drug and alcohol cases a year . Cases the hospital is not equipped to deal with,
“Our emergency department sees five times the number of behavioral health visits than our community mental health center.”
And the cost? Mat Su Regional Hospital charged services totaling 23 million dollars in 2013, and much of that went unpaid, due to inadequate insurance coverage, or no insurance coverage at all, on the part of the patients.
Mat Su Health Foundation conducted a health needs assessment for the Mat Su area a couple of years ago. That survey pointed to alcohol and substance abuse, and mental issues, collectively referred to as behavioral health, as the top health concern in the Mat Su. Data was collected from 65 interviews with crisis responders in all fields.. health, law enforcement and first responders… and through public forums:
“And we heard at these forums that people were waiting 90 to 120 days, particularly children, to get a mental health appointment. We heard from adults about the struggles of accessing care specific to mental health or substance abuse services. And we chose to look at the crisis response system specifically, because when you look at why are people presenting to the emergency department, it shows where or how they might not be accessing services in the community to prevent the crisis. ”
The report’s results are not encouraging: behavioral health impacts the community in a variety of ways.. all of them negative. Here’s a few facts that leap out:
Alcohol and drug abuse is a factor in half of Mat Su suicides and homicides. 20 percent of Mat Su high school students said they have considered suicide. Mat Su’s suicide death rate is twice the national rate. And, crisis response adds 1.6 million dollars to law enforcement costs.
Don Bennice is CEO of Alaska Family Services, which provides alcohol and drug abuse programs in Palmer. Bennice praises the report as the first time the needs have been clearly outlined. He says the Valley’s rapidly changing demographics has brought its share of problems.
“I think there’s quite a bit of services provided in the Valley, it just hasn’t been coordinated real well. And this survey is helping us to identify where we need to move and shift things around to cover the need. The funding has been kind of a difficult issue to deal with, because it has been pretty much sporadic in terms of how it has been applied. And I think that is what is going to happen is that funding will decrease, but yet the population of the Valley is increasing, so that by itself creates a huge problem.”
The report’s findings agree with Bennice : funding, or the lack of it, is a contributing factor.
Elizabeth Ripley says the state Department of Health and Social Services is responsible for providing behavioral health services through state operated programs. The agency’s Division of Behavioral Health provides grants designed to address community needs for crisis response, but Ripley says, the grant system is not working for Mat Su.
“In Mat Su we hold 12 to 13 percent of the state’s population, and yet we receive four percent of the share of community based behavioral health funding. And so Mat Su is not adequately resourced by the state. In the last fifteen years our population has doubled from fifty thousand to almost one hundred thousand people, but the funding for our community mental health center has stayed flat.”
Albert Wall, director of the Department of Behavioral Health, says he’s read the report and appreciates the work Mat Su Health Foundation has put into research and assessment. Wall says that DBH is looking for ways to improve service delivery in the state. He says that there are many challenges the state takes into account when awarding grants, like the high cost of service in rural areas, but that
“a strict population approach is not the most effective method of making grant determinations.” Wall says Mat Su’s rapid growth will be taken into account in coming grant cycle, and that he looks forward to working with Mat Su providers on the issue.
Ripley also points out that expansion of Medicaid services could help the more than 2000 Mat Su residents who have some type of mental illness and would be eligible for Medicaid under the ACA.
She says, until the problem of funding is solved, the status quo won’t change.
“Right now, the emergency room physicians at Mat Su Regional essentially have two places they can send someone.. home or to Alaska Psychiatric Institute.”
Ripley says Mat Su Regional only has two beds to serve psychiatric patients. When they are filled, others in need are diverted to the Anchorage facility.