Mental Health

PrairieCare expansion means more beds for youth in mental health crisis

A hospital bed sits behind a curtained window.
An examination room at the Rainy River Medical Center in International Falls sits empty behind a curtained window, through which staff can monitor patients who may be having a mental health emergency.
Evan Frost | MPR News 2019

Like much of the country, adolescent mental health care needs are increasing in Minnesota. Todd Archbold, the CEO of PrairieCare, decided to expand his program to meet the demanding needs.

He talked to All Things Considered host Tom Crann about his choice and the future of care.

What does this expansion look like in terms of how many beds and where is it?

We're in Brooklyn Park, Minn., and we currently have 71 beds for children and adolescents. And this expansion of 30 beds will bring us to 101.

Tell us how these beds and units will typically be used.

Most of the time, individuals will come to us presenting in a crisis, About 80 percent of them will come from other hospitals, emergency rooms and oftentimes, that's where we come into play.

We get phone calls from medical directors and nurses looking for open beds, and if we have them, we do our best to transfer them safely to our facility where they'll receive anywhere from about seven to 12 days of care.

Is this largely for patients in the Twin Cities or are the needs wider?

We see patients from the five state area, believe it or not. It's certainly more concentrated in the metro but with a lack of beds and maybe more so mental health providers, the metro areas is where health care generally exists. And we get patients who've traveled hundreds of miles.

In fact, it was nearly 20 years ago, that the original vision for PrairieCare as we see it today began because at the time we were Prairie St. John's in Fargo, N.D., and about 25 to 30 percent of our patients were coming from the Twin Cities metro typically have experienced a crisis already. So people will travel for the care and we want to make sure it's as accessible as possible and close to home.

What has stood in the way traditionally, over the years of providing the services at the level that's needed?

I would say first of all, there is, or has been, a hospital bed moratorium in Minnesota. Most states have a way to regulate the licensing of beds. In Minnesota, it's been a moratorium and a public interest review by the Department of Health.

That's actually been temporarily lifted to allow any health system in the state to provide more ready access, one less barrier in place if they want to add either mental health or substance use beds in the state.

And a lot of people might be surprised to hear that — a moratorium on hospitals. What was the purpose of that?

This started back in the 70s. As we were working in psychiatry, more so on deinstitutionalization and trying to create more community-based services, this was just one of the ways to make sure that any inpatient bed, psychiatric or not, really had a purpose and was in the interest of the public.

What actions have you taken?

One of the things that we've been working on as a community that primary care has kind of been leading is something called the Mental Health Collaboration Hub. Every day, we know there are dozens of youngsters and adults who are in hospitals, emergency rooms, other boarding and county administration buildings, even detention centers, who need a safe healing place to receive care and treatment.

And there are hundreds of providers across the state — each that offer very specific services —and finding those matches can be difficult. So the Mental Health Collaboration Hub has really been kind of started as an organic kind of grassroots efforts of providers coming together, trying to help share which services are offered and find these specific matches.

So what happens is, for example, a busy ER will input data on a case and the system will automatically match them. Since this last spring, we've been able to help about 110 kids get out of those boarding situations and into a safe healing environment.

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