A part of the problem, or a part of the cure?

There are few silver linings to getting cancer in Minnesota. Here’s one: You’ve got a better shot at getting treatment for it — and fast — than if you were diagnosed with a mental illness Several speakers at a public hearing on a proposal for a new mental health facility in Woodbury Tuesday night repeatedly made the comparison between the two illnesses.

“If teenagers with cancer were sent home from emergency rooms without treatment because there were no oncology beds available, we would be outraged,” Dr. Stephen Setterberg of Prairie St. John’s told a Department of Public Health hearing on his for-profit firm’s proposal to build a 144-bed mental health facility in Woodbury. The proposal needs the approval of the Legislature because of a statewide moratorium on new hospitals.

Not a heck of a lot has changed since MPR produced its 2004 series, Bad State of Mind, chronicling the difficulty in obtaining mental health treatment in Minnesota. The chief complaint then — a lack of beds for people needing immediate help — is the chief complaint now. And Minnesotans need help.

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But some existing hospitals think Prairie St. John’s proposed cure will further erode the Minnesota mental health system. The non-profit institutions are worried that the Prairie St. John’s will do a good job of meeting its promise to recruit psychiatrists and other mental health professionals by recruiting them from their already-understaffed institutions.

Kathy Knight, the administrator of behavioral services at Fairview Hospital, said the number of beds available for mental health patients isn’t the problem. “We have a provider shortage,” she said. Over the holidays, she said, “I had 16 beds, and no doctors. We’ve recruited all over the country. It’s an enormous struggle and a continuing drain.”

An official at Regions Hospital said an opening for a psychiatrist went unfilled for more than a year.

That’s the problem the Legislature will have to face. Hospitals are concerned about retaining what few mental health professionals they have. People with loved ones in need of mental health treatment, however, could not care less about the long-range impact. They want — and need — help and they can’t wait for politicians, hospitals, and insurance companies to fix a broken system.

Clayton of Eagan, who didn’t want his last name used, had little good to say about his experience navigating the mental health system in Minnesota recently. His wife needed hospitalization. “We went to Fairview because it was the only one in town with a bed. We arrived at 9:15 a.m., admitted to the ER at 9:45. At 10:30 we began waiting for a bed upstairs. We waited until 7:30 p.m. When we got upstairs, it appeared no one was in charge. It was not clean. The staff was disorganized. Patients were strapped in, out of control. There was no way I would let my wife reside there. We arrived home at 10:30 p.m., and my insurance paid $2,600 for a day of chaos. People should be able to get help when they need it.”

All Denise Rodriguez, a Twin Cities schoolteacher, knows is that the system failed her brother, who made good on his plan to kill himself last year. She said he drove to St. John’s Hospital in Maplewood after deciding he wanted to live, but the hospital doesn’t have a mental health facility, and when he was transferred to Regions Hospital in St. Paul, he wasn’t allowed to see a doctor on the same day and, she said, he didn’t get the specialized care he needed. He drank Drano and eventually killed himself. “In mental health,” Rodriguez said, “you only get one chance.”

Judy Johnson, of Woodbury, called the police when her daughter was threatening to kill herself. She she was told by one provider that it could take up to a year. “I was referred eventually to Prairie St. John’s,” she said, “and thank God.”

Not all people with personal stories were embracing the idea of more options. “I have a brother in law who saw a psychiatrist,” said resident Rick Dixon. “My brother in law looks worse. It doesn’t work, so I wouldn’t be for it.”

The Department of Public Health will make a recommendation to the Legislature by the end of February. Still unclear, however, is how Prairie St. John’s is going to make money and solve the problem at the same time. If hospitals could make money on mental health treatment, they’d provide more of it. If psychiatrists could get higher payments from insurance, they wouldn’t move to other states.

And that’s the heart of the problem. They can’t.