State leader praises mental-health intervention

The head of the state's Addictive and Mental Disorders Division lauded Flathead County's crisis intervention programs at a meeting in Kalispell Wednesday.

Joyce DeCunzo, administrator of the division, made the remarks during a presentation to the Local Advisory Council to the Mental Health Oversight Advisory Council.

She said lower state hospital admissions from the Flathead evidence effective community programs.

DeCunzo came to present items in the state's strategic plan targeted for legislative budget requests. She said the plan grew from a series of meetings across the state.

"I was on the job one day when the staff took me on the road for a listening tour," she said.

DeCunzo said about 300 people met with her and other staff members in nine or 10 communities.

"The real priority thing that people told us they wanted was reduction of stigma," she said.

She said people want their communities to understand these disorders as no different from physical conditions such as broken legs. DeCunzo said education is the key to overcoming that stigma.

She said crisis stabilization programs were another priority she heard in every community visited.

"You are really lucky that you still have psychiatric beds in your hospital," she said. "You are one of a handful."

DeCunzo explained that crisis stabilization was needed for people who have "a blip" in their mental disorder, such as a need for medication adjustment. She called it an "in-between" place before commitment to the state hospital.

She said an in-between place also is needed to serve people ready for release from the state hospital but not quite ready to go straight to independent living.

DeCunzo said the strategic plan also reflects the demand she heard for the state to pay only for evidence-based services.

"In other words, this service ends up with some kind of good result," she said.

She called Programs for Assertive Community Treatment examples of evidence-based services. This approach uses a team of professionals who treat mental health disorders outside clinics.

The department's legislative requests includes increasing these treatment slots from 140 to 335 in the 2006 state fiscal year and to 350 in 2007.

Other strategic plan items to be proposed to the Legislature include:

. Approval of the state seeking a waiver of federal regulations that would result in more Medicaid funding.

. Five field-based (outside Helena) department representatives in state fiscal year 2006-07 and 5 more in 2008-09.

. A program officer for the waiver program for Medicaid funding.

. Full training for staff in the areas of violence, seclusion and restraint.

DeCunzo, who became the division administrator in January, said the department was continuing to collect data to solve problems such as overcrowding at the state hospital in Warm Springs.

"We're trying to find out who that person is in the state hospital," she said.

In the process, she said the department discovered that 57 percent of the patients come from emergency or court-ordered admissions. Typically, a patrolman drives the handcuffed patient to the hospital.

During the one- to five-day period before a commitment hearing, the hospital performs all manner of tests and assessments as a result of that admission. After the hearing, she said, about 50 percent of the people don't return to the hospital.

DeCunzo said other counties need to follow the example of Flathead of providing crisis intervention at the community level to determine who needs state hospital care.

In response to a question, DeCunzo said she believes the requests stand a better chance of legislative passage than in the past few years because the state has more money. She pointed out the new tobacco tax will add $38 million for other health programs.

"Times were tough the last couple of years," DeCunzo said. "We're going into this legislative session with the general fund in a much better condition."

Reporter Candace Chase may be reached at 758-4436 or by e-mail at cchase@dailyinterlake.com.