The country is looking to strengthen access to young people with serious mental health problems

BISMARCK – Throughout her 25 years as a school social worker, Michelle Vollan can’t remember a time when the number of serious youth mental health cases requiring hospitalization was higher. as it was after COVID.

Vollan has seen anxiety disorders on the rise, and with that, anxiety in those attending and grades dropping for those affected. At the extreme end, suicidal thoughts and self-harm increased leading to psychiatric hospitalizations.

And while the spike two years ago that led to 25 psychiatric hospitalizations at the Bismarck middle school where he works has subsided, he said, the overall situation remains worrisome.

“I think, based on my experience, it’s increased a lot,” Vollan said, adding that hospitalizations have been cut in half this school year. However, I think there are a lot of kids with anxiety, depression, who can’t cope…those numbers haven’t gone down.

Schools are never meant to be on the front line of dealing with young people’s mental health issues, but they often are.

Carlotta McCleary, executive director of the North Dakota Federation, said: “North Dakota has a mental health crisis that we are in the midst of, and our state is legally obligated to serve children who may be experiencing that. what they call serious emotional problems or disorders of Children’s Mental Health Families.

McCleary said about 18,000 youth in the state need treatment for serious mental health problems, but few are getting the full support they need through ongoing services.

According to his organization’s figures gathered through open records requests, only 73 young people were treated by state human services centers in the past two years. Those numbers have increased to 966 in the 2023-2024 fiscal year, but are still far from meeting the needs of the population.

McCleary said: “We serve very little children. “Where does that pressure go? It goes to our schools.”

McCleary also said there has been an increase in young people dealing with severe anxiety, which leads to the snowballing effect on attendance and grades to more severe levels.

“We know that children who go to school do better. Their results are better. If they are able to be in school, on time and in attendance and have no attendance issues, their outcomes are better,” McCleary said. “Anxious children have a lot of trouble, sometimes (with) going to school and getting to school on time because of anxiety.”

Left unchecked, some youth turn against the juvenile justice system and later, the adult justice system. According to recent statistics from the Department of Children’s Services, 74% of youth coming through the system have mental health issues.

Two programs being rolled out statewide could begin to address access gaps, McCleary said. This includes a $3 million federal grant to implement a Child Care System for youth from birth to age 21 in two state locations as well as a program to convert all clinics in the county into Centers of Public Behavioral Health.

“I believe it will make a difference,” Vollan said of the programs.

Monitoring systems are being developed at the Lake District Human Service Center near Devils Lake, which includes the Spirit Lake and Turtle Mountain locations, and the West Central Human Service Center located in Bismarck, including MHA community and standing sections. Stone terms.

The implementation stems from a 2018 behavioral health study commissioned by the Legislature to investigate strengths and gaps in youth behavioral health services, said Katie Houle, director of clinical in the behavioral health division at the Department of Health and Human Services.

System of Care is a set of philosophies and values, he explained, that guide and coordinate the care of individuals and families dealing with mental health problems by breaking down barriers between services that prevent adequate care.

Oftentimes young people with mental health issues can feel like they’re a “hot potato,” Houle said, “being sent to different places and places and not feeling like they’re getting the services they need. “

Schools, GPs and outpatients and the juvenile justice system all have their own ways of talking and interacting with young people, so strengthening them all in a holistic approach that includes the family and the wider community is important. to build a good level of service, he said.

“Of course it will take strategic planning and collaboration across juvenile justice, child welfare, schools, public and private health services, and, in particular, to think about how we work with community organizations. our families and young people who have these problems,” said Houle. .

The second program being developed, and part of a long-term process, has been to identify clinics to begin transitioning to state CCCBCs with the goal of eventually transitioning to all areas eight toward this certification, said Daniel Cramer, director of the behavioral health clinic. DHHS clinics.

Central Human Services Center in Minot was the first site selected to actively move to CCBHC status, Cramer said. Northwest Human Service Center in Williston and Badlands Human Service Center in Dickinson now serve as CCCBCs.

Cramer says this includes prioritizing care coordination and includes hiring behavioral health liaisons at each clinic to build critical relationships with community partners, as well as care coordinators to provide through a targeted care system.

Certified clinics will be required to have crisis services available 24/7, to develop comprehensive services so that individuals do not have to coordinate this through different providers, and to help those in need get the different care they need.

“That’s what we’re all working toward,” Cramer said. “How we can open our door wide for those in need, and then ensure that when a need is sought and/or identified, we work with all of our partners to build to meet that need.”

Vollan said the federal system for dealing with mental health issues has a comprehensive plan called “wraparound,” where it seemed easier to know what needs and options were available and not just for young people at risk of mental health but also their wider families.

This practice has declined over time, and treatment methods and techniques have increased.

“When we were around, like in the old days, it was your team, how do we talk about the supports that not only our children need, but also our parents, siblings, other parts that you see them,” said Vollan. “It left a lot of our families with the question, what do we do? Where do we go when my child is in trouble?”

Houle said DHHS has contracted with the state’s Wraparound Action Center to assess where North Dakota’s system is and how it can be restored. This includes specific measures to interact with families and create different plans where one person holds each member of the group – around the child – responsible.

“A lot of parents and carers of children with complex needs are exhausted, they have a lot of carer pressure, all those things,” she said. This may include counselors, religious congregations, coaches and other relatives to provide support.

“In the right direction, I feel that round-ups and other forms of care coordination will work together with medical treatment services to make sure that the right children get into the right place at the right time, ” he said.

Other broader support systems may also include addressing key factors of instability and stress, including addressing poverty, lack of access to transportation, and insecurity. not food and housing, Houle said.

This story was published on NewsCoopND.org