LINCOLN — Nebraska needs to study the systemic shortcomings and gaps in the state’s mental health care system for young people and adults, members of the Legislature’s Health and Human Services Committee heard in a Wednesday hearing.
Then the state needs to step up, senators were told.
Prosecutors and public defenders, mental health providers and people with mentally ill family members told the committee it should study what other states and governments do better, how they pay for services and how they coordinate their work.
Sarpy County Attorney Lee Polikov, Douglas County Public Defender Thomas Riley, Region 6 director of mental health services Patti Jurjevich and Douglas County Sheriff’s Sgt. Jared Langemeier described a system in need of state help.
Jails doing too much
Polikov said local officials, care providers and others are doing their best to support individual projects, such as a new mental health project with the University of Nebraska Medical Center at the new Sarpy County Jail.
He said jails have become the “de facto” largest mental health facilities in many counties. The Legislature needs to boost funding on mental health and help counties avoid duplication of services so they can focus on addressing unmet needs, he said.
Riley said he’s been around long enough to see Nebraska shift its approach to community-based care and close regional mental health facilities that it might now need in addition to that community care. He said most agree jail is not the right place for the ill.
“We might not agree on the specific remedies, but we all agree that this needs to be addressed,” Riley said.
Reasons for study
State Sen. Mike McDonnell of Omaha said he proposed Legislative Resolution 199 to push mental health care discussions forward between the courts, probation, law enforcement, prosecutors and defense attorneys, schools, higher education and local leaders.
Sen. John Fredrickson of Omaha is pursuing related interim studies on the availability of mental and behavioral health care providers.
“The State of Nebraska is facing an urgent behavioral health crisis,” McDonnell said. “Nebraska has unintentionally shifted the responsibility of caring for the mentally unwell to our law enforcement and correctional facilities.”
He testified that 43% of inmates at the Douglas County Jail have been diagnosed with mental health concerns. Martha Wharton, an assistant public defender in Douglas, said some inmates who need treatment in order to stand trial face months-long waits.
“I think if they were afflicted with other illnesses, they would be getting the care they needed,” Wharton said. “Because it’s mental health, it gets pushed back.”
Lengemeier, of the Douglas County Sheriff’s Office, said his agency takes about 100 people every month into emergency protective custody for their mental health. He said about 1 in 10 of them faces involuntary commitment proceedings.
Families are often desperate to find care for their loved ones, he said. But there are too few beds for in-patient care. Several suggested Nebraska should add caseworkers to ensure that adults who are no longer under their parents’ care take the medications they need.
Larry Derksen of No Shame Ministries testified about his family’s years-long fight to get help for his nephew. He said family couldn’t get and keep his nephew stable and that he forced a police officer to shoot him at an Omaha Target this winter.
“For months and years, my family pleaded with mental health facilities to help us,” Derksen said. “They would not talk to us because Joey did not want that.”
Derksen said the state needs to consider an all-hands approach to mental health care providers in much the same ways the medical community responded to doctor shortages — by embracing something like physicians’ assistants for mental health care.
Other options testifiers discussed additional mental health training for police officers, a potential middle-step mental health facility with a secure wing and transition services for people who need to stay on their medications.
Jurjevich, the Region 6 director, focused the committee on recent changes the Legislature made in provider rates and said the state’s budget for regional mental health care has not kept pace with costs, which reduces how many people they can serve.
“This is a significant setback for the behavioral health system,” she said.
McDonnell, a former first responder, closed the hearing by saying, “no level of government is going to solve this problem by themselves.” He called the problem “too big.”
“We’ve got to start by talking amongst ourselves, the people who deal with this issue every day, and listening to them and taking their experiences and their ideas,” he said.
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