Before It Gets Better: Lack of West River Services Part of Statewide Issue
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Rapid City is isolated when it comes to mental health care access and coverage. The regional hospital has just 44 beds for long term care patients.
The South Dakota House of Representatives has publicly acknowledged the need for additional services in western South Dakota.
A legislative task force is looking at access for those who have a mental health crisis.
The last year has been a real struggle for Katy Urban and her Rapid City family.
Their thirteen year old daughter was hospitalized repeatedly when she tried to take her own life.
Urban says within two months, her daughter was hospitalized four times.
“There was little help in between,” Urban says. “We would go to regional west. She would get out. We would get in with a counsellor as quickly as we could. Then she would have another attempt and she’d go back in. Finally after the fourth attempt, they said she needs some sort of long term treatment.”
Doctors were ready to send her to the state hospital in Yankton. Urban didn’t think that option would work for her daughter. Distance was one concern. Urban says she was unsure how she could participate in her daughter’s treatment with a five hour drive. But there weren’t any other options…
“And she needed long term care, so we started looking at other places,” Urban says.
They found a treatment center with a good reputation two states away, in Colorado Springs where they have family.
“It was excruciating to take my child to an unfamiliar place and drop her off and know that I could only see her a couple times a month," she says. "It just wasn’t feasible for me to stay down there.”
Urban says dealing with a mental health crisis is never easy but bigger cities have more options. She says West River has enough mental heath issues to warrant more attention and options on this side of the state.
Urban is the community relations manager for Rapid City area schools. She says seven times in the last 16 months she’s had to inform district parents a student has taken their own life.
“Just in the Rapid City Area Schools,” Urban says. “We’ve had dozens of other kids that have had serious attempts, and hundreds of other kids that talk about wanting to end their lives. This happens all the time. So, I would say we’re in a crisis and something needs to happen, and it can’t be that we have to ship them out all the time. It’s just not good for our community.”
And it’s not just teenagers, people in every age group need mental health care. State and local governments are looking at early intervention methods, that could save costs on the back end.
Pennington County Sheriff Kevin Thom says it’s been a struggle for a number of years on the western side of the state.
“We continue to see our need for mental health services escalate,” Thom says. “In particular, us at the jail, we’re one of the largest, if not the largest, mental health providers in South Dakota. Jails across the country have become large providers of mental health services.
That’s why the sheriff’s office opened the Pennington County Care Campus. It’s a $14 million dollar complex across from the county buildings that provides mental health and substance abuse services. It was funded by city, county, and private donations. The campus brings together detox, safe solutions and health and human services all under one roof. Housed within that campus is a crisis care unit, in partnership with Behavior Management Systems of Rapid City.
Thom says the Care Campus addresses street level crisis management, which is mean as an alternative to jailing individuals.
He says the campus creates efficiency for the sheriff’s office, but he says it’s more of a stepping stone for a higher level of care.
“It’s a first step for us locally in trying to better utilize our resources more efficiently,” Thom says. “And get the right services at the right time for the individual that’s using the facility. Ultimately, crisis care can be a referral to a higher level care.”
Thom says the justice system needs more support from other service providers or alternative programs that can divert people into mental health services.
“It’s a huge issue to get your arms around.”
That’s State Representative Michael Diedrich of Rapid City.
He’s one of 17 state lawmakers on the Access to Mental Health Services task force.
Diedrich says the group is looking at the high prevalence of behavioral health issues in the state, and the lack of well coordinated resources.
Last legislative session, the House passed a resolution recognizing the need for additional mental health services in western South Dakota. While there has been talk about a state run West River facility, Diedrich says a brick and mortar facility isn’t politically feasible at this point.
“Initially, we need to look at what alternatives are there that are more cost effective,” Diedrich says. “How do we provide additional services, and coordinate services, and create more access in a way that doesn’t create much significant additional costs at this point.”
The task force is looking at licensing requirements for mental health professionals to address the personnel shortage in the state. Diedrich says South Dakota’s psychiatrists are aging out of the workforce.
Randy Allen is the clinical director of Behavior Management Systems in Rapid City. It helps run the Pennington County Care Campus. Allen agrees there’s a workforce shortage in west river, and across the state.
“Everybody around town, that is a fairly large provider around town, has a waiting list to be seen, just for outpatient counselling,” Allen says.
Allen says part of that comes from an increasing need for these kinds of services. But the whole state struggles to attract qualified professionals to provide those services.
Allen says a Rapid City group will push for a legislative bill to simplify the licensing requirements for those getting a degree in counselling.
“If they pass that, it would come more in line with what the requirements are for social work and a license in social work,” Allen says. “Other states have that, like if you go down to Colorado, they all take the same test at the same time and get the same license to practice in Colorado. South Dakota, if they pass this legislation, will take a step forward.”
But it’s not just about workforce shortages, rural access to mental health care is also a struggle.
The state task force on mental health convenes again in November. They’re expected to bring recommendations for the next legislature to consider.