Duluth hospitals accused of ignoring mental health in their plans
Duluth News-Tribune - 8/21/2019
Aug. 21--The leader of a statewide mental health organization is taking issue with hospital building plans in Duluth, saying they bypass the mentally ill.
"The investments in Essentia Health and St. Luke's to make Duluth a medical destination completely ignores the compelling needs of people with mental illnesses in the region," wrote Sue Abderholden, executive director of the National Alliance on Mental Illness-Minnesota, in a letter to the health system's executives.
"We find it unacceptable that $96 million of state funding, millions of dollars from the city and millions of dollars of private funding will not be used to address the incredible unmet needs of children and adults with mental illnesses and their families in the Arrowhead Region."
The letter, which Abderholden shared with the News Tribune on Tuesday, was dated July 14 and addressed to Dr. David Herman, CEO of Essentia, and Eric Lohn, then-interim president of St. Luke's, with copies to hospital board members and numerous state and local officials, including Minnesota Gov. Tim Walz and Duluth Mayor Emily Larson.
The two health care systems plan to spend a combined $1 billion over the next decade on new construction of medical facilities in Duluth. Local and state money will be invested on infrastructure to support the development. But Essentia's plans keep behavioral health care in old facilities, said Dave Lee, director of Public Health and Human Services for Carlton County and a member of the state Advisory Council for Mental Health.
"If it's a priority, let's make it look like a priority, and not have it in rehabbed old rooms in the old city hospital -- Miller-Dwan," Lee said. "You know, mental health isn't glitzy but it's vitally important for all of us and for our community."
Diane Holliday-Welsh, operations administrator for behavioral health at Essentia, noted that the new construction will replace Essentia Health-St.Mary's Medical Center, which has never included inpatient mental health treatment. She added that Essentia completed a $7 million renovation of its mental health unit at Essentia Health-Duluth -- often still referred to as Miller-Dwan -- just a couple of years ago.
Both Lee and Abderholden noted that mental health consistently has been identified as a top priority for Northeastern Minnesota in community health assessments. But, Abderholden wrote, the health systems seemingly were adding no inpatient psychiatric beds and were not creating a psychiatric emergency room.
In a separate letter dated Aug. 9, Julie Juntti, who chairs the six-county, three-tribe Arrowhead Behavioral Health Initiative, urged the two health systems "to include increased capacity to address mental health in any clinic or hospital expansions, particularly those supported by taxpayer resources."
Holliday-Welsh confirmed that Essentia isn't adding inpatient psychiatric beds or a psychiatric emergency room. Essentia is focusing more on prevention and on treating patients closer to where they live. An example, she said, is expanding its telepsych services to the "53 corridor" -- Virginia, Ely and International Falls.
In a July 24 letter responding to Abderholden, Herman vigorously defended Essentia's response to mental illness.
The new emergency department will have four specially designed rooms for mental health patients in a unit with its own entrance, Herman wrote, and four additional rooms will be available. Moreover, Essentia Health-Duluth will have a new "behavioral health crisis stabilization unit" that will hold up to six patients for up to 72 hours, with a goal of limiting emergency department visits to no more than 24 hours.
In a statement, St. Luke's CEO Kevin Nokels said the hospital's current construction focuses on expanding its emergency room and its cardiac catheterization labs, but he said behavioral health was included in the former. It will increase from one to four the number of "dedicated behavioral health rooms" in the ER, he said.
Essentia Health-Duluth provides 38 inpatient beds for adults and 14 for children and adolescents, Herman wrote.
But it's not enough, said Lee, who noted that patients with mental health issues in the region often are moved to Fargo, N.D., or the Twin Cities because there's no room for them in Duluth hospitals. Local hospital officials tell him that a shortage of mental health professionals keeps them from adding more beds for patients they wouldn't be able to treat, Lee related.
Lee isn't buying that.
"Yes, there is a shortage, but the organizations that prioritize it get the doctors that they need," he said.
In an interview, Abderholden also said more inpatient psych beds should be a priority.
"If you had cardiac patients in the ER for more than a day, or being transferred across the state, you would have new cardiac beds tomorrow," she said.
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