Hospitals apply for more psychiatric beds, Alaska Justice Forum article supports need

Information from "Alaska's Lack of Psychiatric Beds and Consequences," Alaska Justice Forum, Summer 2017, was used in a recent Certificate of Need (CON) hearing to support a request for additional psychiatric beds.

In May 1968, at the time of this photo, API had 225 beds. It has 80 now.
Christine M. McClain papers, Archives and Special Collections,
 Consortium Library,UAA. Jim Balog, photographer

Alaska Regional Hospital and Mat-Su Regional Medical Center both presented cases and supported each other's requests for expanding behavioral health units to the CON board on August 16 in Anchorage. Mat-Su Regional is applying for 36 beds for behavioral health and substance use disorder patients. Alaska Regional Hospital is seeking 24 psychiatric beds, 12 of which would be secure.

"We are desperately in need of more resources," Alaska Regional CEO Julie Taylor told the CON board.  She presented historical information, taken from the Justice Forum article, that API used to have over 200 beds when it began operating in the 1960's. It now has 80 -  with only 50 reserved for adults. The rest are for adolescents, forensic cases and people with dementia and other disabilities who have no other options for placement.

Taylor also presented a chart that appeared in the Forum showing how the de-institutionalization movement of the 1960's and 70's shifted the population of adults with mental illness from medical institutions to jail.

The lack of beds is particularly worrisome as the state takes moves to reduce the number of people with mental illness who are in jail, Taylor said. "We need to be ready with the resources," she said.

Mat-Su Regional will serve both behavioral health and substance use disorder patients. Alaska Regional plans to focus on behavioral health.

Both requests received strong support from service providers, consumers of mental health and substance abuse disorder services, and family members.

A second CON hearing will be held at Mat-Su College on August 31 at 4:30 p.m.

Corrections aiming to be gold standard in treatment of mentally ill

The Department of Corrections (DOC) is the largest provider of mental health services in the state of Alaska. With 33,000 bookings a year, 65% of those booked qualify as beneficiaries of the Alaska Mental Health Trust Authority, including 23% with a serious mental illness, according to Adam Rutherford, Chief Mental Health Officer for DOC.

In many areas, Alaska lags behind other states, but not in its treatment of the mentally ill in its correctional institutions, Rutherford said.“We are practicing evidenced-based interventions, we are a leader in this area,” he said, adding, “We want to be the gold standard in mental health care.”

L-R: DJJ Clinical Director Shannon Cross-Azbill, DJJ Chief Probation Officer
Heidi Redick, DOC Director of Health and Rehabilitation Services
Laura Brooks and DOC Chief Mental Health Officer Adam Rutherford.

Rutherford, along with Laura Brooks, Director of Health and Rehabilitation Services for DOC, Shannon Cross-Azbill, Clinical Director for the Division of Juvenile Justice (DJJ) and Heidi Redick, DJJ Chief Probation Officer, spoke at UAA earlier this month in a program sponsored by the UAA Justice Club on how the mentally ill are being served in both the adult corrections and juvenile justice.

While it is often difficult to diagnose juveniles, DJJ Clinical Director Cross-Azbill said that the majority of those in DJJ have a mental health diagnosis including substance abuse, ADHD, depression and trauma-related disorders. They’ve recently been keeping track of Fetal Alcohol Syndrome Disorders and found 47% of the juveniles may be experiencing this, she added.

The panelists attributed the high numbers of those with a mental illness in both juvenile and adult systems to be partly in response to a lack of resources outside their systems.

Laura Brooks, who oversees all of DOC’s Health and Rehabilitative Services (HARS), explained the growth in prison treatment of the mentally ill as symptomatic of a shift in the 1960s away from funding state psychiatric hospitals and moving toward community mental health centers that were inadequately funded. Eventually, many of those with mental health issues ended up in correctional institutions, she said.

Not only is DOC Alaska’s largest behavioral treatment center it is also the state’s largest health care provider.  It is also the largest medical facility, largest detox center, and substance abuse treatment center. The behavioral health staff has 21,000 contacts with offenders a year, according to Rutherford. The HARS staff of 200 sees 5,000 patients a day inpatient and 4,000 a day outpatient, according to Brooks.

DOC has followed the national movement to screen people coming into the system to assess : 1) criminogenic risk, 2) need for substance abuse treatment, and 3) need for mental health treatment.

The goal is to have people in a better position when they leave the facilities than when they entered, Rutherford said. This is important, he added, because most of those who are incarcerated return to the community.

Mental health care among juvenile and adult correctional populations discussion April 6

Join the UAA Justice Club for a panel discussion of mental health care among juvenile and adult correctional populations, the last in our National Criminal Justice Month 2017 series of discussions.

Date: Thursday, April 6
Time: 7:00–8:30 p.m.
Location: UAA/APU Consortium Library, LIB 307
Admission: Free and open to the public

Providing mental health care has become an increasingly crucial aspect of modern correctional rehabilitation.  Nationally, more than half of prison and jail inmates have mental health problems, and probation/parole departments provide essential mental health services to their clients.

Learn how Alaska tackles these issues at a panel discussion with experts from the Division of Juvenile Justice and Department of Corrections:

Heidi Redick — Chief Probation Officer, Division of Juvenile Justice
Shannon Cross-Azbill — Clinical Director,  Division of Juvenile Justice
Laura Brooks —  Director of Health and Rehabilitation Services, Department of Corrections
Adam Rutherford — Chief Mental Health Officer, Department of Corrections

Dr. Myrstol co-authors article in Community Mental Health Journal on mental health among the homeless

Dr. Brad Myrstol, Justice Center faculty and Director of the Alaska Justice Statistical Analysis Center, co-authored an article, "Does Context Matter? Examining the Mental Health Among Homeless People," which was published online in June in the Community Mental Health Journal.

The co-authors are Dr. Kevin Fitzpatrick, Department of Sociology & Criminal Justice, University of Arkansas, Fayetteville; and Elizabeth Miller, Department of Sociology, University of  Oregon, Eugene.

The study examines how place and social capital interact to influence depressive symptomology among the homeless. The research occurred in two very distinct locales in two different states, Birmingham, Alabama (urban) and Northwest Arkansas (suburban/rural). Social capital refers to the social networks and relationships an individual is involved in.

Dr. Rivera presents at UAA's first Healthy Minds Conversation with the Chancellor and Provost

Dr. Rivera (at podium) discusses health problems of
female victims of crime.

Dr. Marny Rivera, Justice Center faculty, and Dr. Gabriel Garcia, UAA Department of Health Sciences, co-presented at UAA's first "Healthy Minds Conversation" on April 22.

They discussed their research on "Health Correlates of Female Victimization" which looked at the effect of race on the health conditions of women who have experienced violence in their lives. Minority women who have experienced violence have significantly increased odds of health problems, including mental health problems.

The goal of the event was to encourage conversation among faculty, staff and students about programs, projects, and research at UAA aimed at supporting mental health.  As the University of Alaska’s health campus, UAA is uniquely situated to take a leadership role in supporting a healthy minds ethos on campus and collaborating with partners both on and off campus.

The program included an overview of the programs in the College of Health, Student Affairs, and the College of Arts and Sciences.  The reports and recommendations from this event will be summarized and distributed.

For more information, contact Pam Cravez, Executive Officer, Communications Directors, pcravez@uaa.alaska.edu The event is available as a UAA podcast.

Dr. Garcia and Dr. Rivera presented to faculty, staff, and students.