The state of Minnesota has made many progressive steps forward in the area of mental health care including their establishment of the few mental health Urgent Care centers in the nation. Support for the wide array of mental health issues from crisis to prevention is an important part of Minnesota’s nonprofit landscape.
In preparation for this research, we spoke with 13 issue experts to better understand the area of mental health in Minnesota. Their insights helped define the scope of this research. (Thank you to those of you who offered your time and expertise!)
Areas of Focus
Children’s mental health – Children’s mental health services encompass both in-school and out-of-school interventions. On the whole, Minnesota has moved toward a model of individualized care for youth to ensure that assessment and treatment strategies are designed to contribute to a holistic model of care. Children’s mental health relies on a trauma informed model of care, which deeply informs their assessment and services.
Crisis intervention – Crisis intervention strategies are often needed as an element of care for those with serious and persistent mental illness (SPMI). Major goals of crisis support are both to dissolve the current situation and to help the individual avoid future crises. Too often a mental health crisis will result in an emergency room visit for the individual. Emergency rooms are ill equipped to provide care for mental health crises. These visits are often costly and result in inadequate care. Crisis intervention strategies such as mobile crisis teams and mental health urgent care can help reduce the number of ER visits.
Culturally competent care – In order for mental health care to be effective, it must be truly accessible. There is a growing understanding in the field that mental health care often needs to be a trusted and integrated part of the community in order to truly be a resource. New immigrants may also be in need of support as they assimilate into a new community. Language barriers, isolation, and the process of moving to a new community are often anxiety producing and can lead to depression. Many effective practitioners strip away the language of mental health and work to help new immigrants become more integrated into their communities and respond to their emotional needs.
Dual diagnosis and issues exasperating mental illness – Alcoholism and drug abuse are often co-occurring in individuals with mental illness. The co-existing issues of addiction and mental health issues are often called a dual diagnosis. While there are some services that focus on dual diagnosis, there is far more support needed in this area. Like addiction, poverty and homelessness often accompany mental illness. Due to stress, instability, and decreased access to medication, these situations can exacerbate mental health concerns and speed up the cycle of a mental health crisis.
Integration of care – In many areas of Minnesota’s mental health care system, providers are identifying the need to approach individual needs from a holistic perspective. For example, there are significant physical health disparities for those with mental health concerns. In line with the national trend, in Minnesota, those with serious mental illness have an average life-span of 24 years fewer than their peers (Health Partners). There is a nationwide shortage of psychiatrists. This trend negatively impacts those in rural areas even more dramatically. Some of this burden can be alleviated through the of telemedicine and training general practice physicians to manage mental health cases.
Lack of residential options – As a result of the economic downturn, Minnesota is experiencing a lack of residential vacancies. There are very few options for residential support outside of the hospital setting. For many, options such a group homes or treatment facilities may be an appropriate fit, but are not a viable or timely option.
Preventative care – Currently prevention is undervalued in the mental health arena. To qualify for services, often an individual needs to have suffered a crisis. This is in many ways a dangerous trend, though there are a few notable exceptions. Minnesota has a strong suicide prevention focus, both for youth and adults. There is also an emerging trend in programming for individuals experiencing their first mental health crisis, which helps to set up systems to prevent recurring episodes.
Serious and persistent mental illness – Individuals suffering from serious and persistent mental illness (SPMI) have a diagnosis of schizophrenia, bipolar disorder, major depression or borderline personality disorder that significantly impairs the person’s functioning. Individuals with SPMI are more likely to undergo crisis, be hospitalized, and require ongoing case management and mental health care.
Stigma – There is a strong need for reducing stigma, or stigma busting, in the mental health community. The negative connotation of a mental health diagnosis and treatment keep many people from accessing care for years. It also builds a wall between mental health consumers and their communities. Stigma busting can take the form of community-based services, mobile care, training practitioners in stigma reduction, and emerging practices that make patients an active voice in their own care.
Veteran mental health – The mental health needs of veterans are as diverse as veterans themselves. The conflicts in Iraq and Afghanistan have resulted in increased numbers of Veterans who have experienced traumatic brain injuries (TBI). TBIs vary in severity. Some instances can lead to long term cognitive and emotional issues. Older and more recently established veterans may suffer from combat related mental health issues such as post-traumatic stress disorder (PTSD); an anxiety disorder can occur following the experience of a traumatic event that involved the threat of injury or death. It is also important to keep in mind that there are many veterans whose mental health concerns are not military related and many who have no mental health issues at all.
Types of organizations
For this research, we are asking experts to recommend up to four nonprofits doing high-impact work in Minnesota, and up to two start-up nonprofits that have the potential to do high-impact work. In particular, we are asking that experts recommend nonprofits doing work across the mental health spectrum. Focus areas may include:
- Addiction support
- Crisis support
- Family services
- Housing for the mentally ill
- Integration with physical health
- New immigrant adjustment
- Patient centered care
- Respite care
- Rural treatment
- Stigma reduction
- Suicide prevention
- Telephone support
- Veteran care
- Workforce shortage
- Youth care
Funding and care for mental health issues is made up of a complex relationship between states, the county, insurance providers, mental health care providers, and consumers. This research will look specifically at the nonprofit entities involved in this relationship.
If you are a professional (foundation staff, researcher, nonprofit staff member, etc.) working in mental health in Minnesota and have insight on nonprofit organizations working in this field, we’d love to hear from you. You may have received an email from us with a link to our survey. The survey will be open until early March 2013. We hope you will share your perspective and insights! If for some reason we have missed you and you think you have a valuable perspective to offer, please contact Jasmine Marrow at firstname.lastname@example.org with information about your current position and background, and we would be happy to send the survey to you to include your recommendations.