New mental health crisis and recovery center opens in West St. Paul, easing psychiatric bed shortage

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Minnesota has been facing a psychiatric bed shortage. In a 2023 Minnesota Department of Health study, the top reason for discharge delays from Minnesota hospitals is a lack of availability of psychiatric beds. The study found some patients were spending as long as two weeks in a hospital waiting for psychiatric bed placement.
There is a new facility hoping to ease some of those pains. The Crisis and Recovery Center in West St. Paul held it’s ribbon cutting on Monday. The facility will have 16 psychiatric beds. It’s run by Dakota County and the non-profit Guild, which provides mental health services.
Deputy Director of Dakota County Social Services Emily Schug and Guild’s CEO Trish Thacker joined Minnesota Now to talk about the new facility.
Use the audio player above to listen to the full conversation.
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Audio transcript
There's a new facility hoping to ease some of those burdens. The Crisis and Recovery Center in West Saint Paul held its ribbon cutting yesterday. The facility will have 16 psychiatric beds. It's being run by Dakota County and the nonprofit Guild, which provides mental health services. Joining me now to talk about this new facility is Emily Schug, the Deputy Director with Dakota County Social Services. Thanks for being with us, Emily.
EMILY SCHUG: Good afternoon, Nina. Thank you so much for highlighting this important project.
NINA MOINI: Absolutely. And also joining us, we're happy to have Trish Thacker, the CEO of Guild. Thank you as well for being here, Trish.
TRISH THACKER: Thanks so much for having me. We're so excited to be part of this project.
NINA MOINI: I want to start with you, Emily, if I could. What was and is the need for psychiatric beds, specifically in Dakota County?
EMILY SCHUG: Yeah. As you mentioned, we see every day just the need for people to have the right kind of supports, as we like to say, the right services at the right time as it pertains to mental health and issues people may be experiencing. So in Dakota County, we're responsible for ensuring that we have a whole continuum of services and supports that people can access close to home.
And the services that we're talking about today are part of that continuum. So having access to assessment and support at the time of the connection-- or at the time of a crisis, and then also being able to access those additional services, residential treatment services that help people build those skills and the capacity for long term recovery.
NINA MOINI: Yeah. Thank you for explaining that, because when we're talking about psychiatric beds, it's not just literally the bed. Correct? It's like a whole holistic approach to serving people. And Trish, I wonder, who exactly will this center serve?
TRISH THACKER: Sure. Most of the people who come through intensive residential treatment services are experiencing either acute or chronic or both acute and chronic mental health crisis, and they will often have some of the more severe diagnoses that we see out in the community. Major depression. Bipolar disorder. Sometimes really severe anxiety, post-traumatic stress, and sometimes all of those things in combination.
And so folks will come to us when sometimes they're discharged from a hospital, from a psychiatric hospitalization, and we're part of the stepdown. And sometimes they come to our facility in order to try to avoid hospitalization. So we're kind of a bridge between intensive outpatient and then hospitalization. So those folks who don't meet criteria for inpatient hospitalization but still need a higher level of care than those intensive outpatient programs offer.
NINA MOINI: OK. And, Emily, you know, 16 beds is very exciting, but it doesn't sound like it's going to meet the entirety of the need. Correct? Can you talk about what it takes to operate a facility like this with 16 beds?
TRISH THACKER: Yes. As you said, the need for these services statewide is great, and we're just really excited to be able to fill a need and gap for these services, again, in our local communities close to home. And part of the really exciting part of this project is this building incorporates really state of the art design or what we call trauma informed design, that really best supports people to heal and recover. And just having not only the services available, but the right kind of setting that really incorporates what we know about trauma-informed design principles has made this a really important project.
NINA MOINI: Can you share a little bit more about what that looks like? The trauma informed, is it the ambiance, is it the feel of the facility, or what is that?
TRISH THACKER: Yeah, great question. So one of the things that we know is just sort of the dignity of people's experience. So some of the elements of the building include that it has private bedrooms and private bathrooms, which not all types of settings like this have. We really had a big effort to promote calming design features.
So for the colors, there's a lot of mural elements that bring in elements of nature. There's a big emphasis on natural light and clear wayfinding, meaning that you can always see the outside from any place that you're in the building.
NINA MOINI: Oh, OK. Thank you. Oh, I'm sorry. Go ahead.
TRISH THACKER: Oh, I was going to say the other thing that's really important is that it is accessible. So it has two ADA rooms and also an elevator for people who may have mobility issues, which is, again, a really important aspect of making sure these services are accessible.
NINA MOINI: Absolutely. Absolutely. Thank you for sharing that. Trish, you know, we mentioned at the top that sometimes Minnesotans are waiting weeks for a psychiatric bed. I know this could be a whole hour, but I'm curious if you could just explain, like, how did we get to this point? What are the barriers to getting people the access they need?
TRISH THACKER: Oh, gosh. Yeah. Let's take that hour.
NINA MOINI: Yeah.
TRISH THACKER: Yeah. I realize, of course, we're not going to. There's so many barriers. There can be insurance coverage. You know, how are we going to pay for services? There's staffing challenges right now across the mental health sector. We're experiencing a shortage of independently licensed and experienced staff to come in and provide that clinical direction, support, and therapeutic service in these kinds of settings. We also know, and statistically we're seeing this come to bear, the effects of COVID and the isolation that happens.
So there's an increased need for mental health services across the lifespan. And so as these needs increase and staffing shortages increase, they're inversely proportioned so that the need increases, the ability to staff decreases, and-- you know, kind of like a teeter totter. And so we end up with these periods of time where there's holes in service-- in what's available for services for more intensive treatment options for people.
NINA MOINI: That was a very good summary. Thank you. And I know it's very nuanced, but like so many other areas, staffing is down. The need is up since the pandemic. It's just overwhelming to think about. Emily, can you explain what, say, the county's role is in providing mental health services and how the facility fits within that? Is it the county and the city and the state and the hospitals and providers, everyone is kind of working together?
EMILY SCHUG: Yeah. You said it really well. A community-based mental health system is really about all kinds of systems and systems and partners bringing different resources and expertise to the table to really create a whole continuum of mental health services. So we do all of this work in partnership with a whole variety of people who are delivering different types of care.
And I think that one of the things that I think we really do well is making sure that we have those connections between all the different services so that we can really meet somebody where they're at at any point in their journey, and then connect them to services that will meet their needs for the long term and do that in a really, what we call kind of person centered way that's really looking at the uniqueness of their situation.
NINA MOINI: OK. And so ribbon cutting was just yesterday, right? The 16 spaces, are they filling up? Or what is going to be the process for actually getting people in the doors? Emily?
EMILY SCHUG: Great. And Trish can speak to this too, but there is a process for people who are looking for this level of service to be able to call and talk to somebody about where they're at in their journey and whether or not they meet eligibility criteria. And then there's a process of managing that waitlist for those services. So Trish might be able to say.
NINA MOINI: Sure. Go ahead, Trish.
TRISH THACKER: Sure. Well for this facility in particular, we're already running these treatment services at a different location, and we're transitioning from one location in South Saint Paul to this brand new location in West Saint Paul. We're moving from these really old buildings that are literally over a hundred years old into this really beautiful and well-designed space.
So people are-- we're going to be one day over in South Saint Paul, and the next day we'll be operating out of this new facility. So we'll be close to full when we when we move in, because we're just transitioning the program and the participants from one location to another. We did stop our intakes temporarily, because it would be really disruptive for someone to come and kind of assimilate into the program and then have to move again.
And we'll open for intakes again about two days after we've transitioned into the new location. So we'll have a few beds that will be available immediately after we move, but we're really moving a highly utilized service from one location to another.
NINA MOINI: All right. Emily and Trish, I just want to thank you both for coming on and sharing this with us. All the best with your efforts. Thank you.
EMILY SCHUG: Thank you so much.
TRISH THACKER: Thank you so much.
NINA MOINI: Emily Schug is the deputy director with Dakota County Social Services, and Trish Thacker is the CEO of Guild.
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