Detox discussions

Panel considers costs, benefits of building facility in effort to mend perceived hole in Flathead's mental-health safety net

A panel of mental-health and law-enforcement experts met Monday to discuss the need for a detoxification center as an alternative to jail for people under the influence of alcohol or drugs.

It marked the first step toward mending a hole perceived in the Flathead Valley's mental-health safety net.

Tom Bartlett, leader of the Local Advisory Council to the Montana Mental Health Advisory Council, said that the Flathead has an excellent system for handling most mental-health crises.

"One thing we do not have is a detox facility," he said. The panel was the program portion of the monthly meeting of the local advisory council. Bartlett said he was following up on comments made at earlier public meetings.

He distributed a summary sheet describing a Community Crisis Center that opened this month in Billings. The facility serves as a single access point for people suffering from co-occurring mental illnesses and substance abuse.

Upon admission to that center, a patient receives an evaluation and referral within 24 hours to either the Psychiatric Department at St. Vincent Healthcare, outpatient treatment or to the Rimrock Foundation for nonmedical treatment.

The new facility is a joint venture of St. Vincent, Deaconess Billings Clinic, the Yellowstone City-County Health Department and the Mental Health Center.

Using the Billings approach as a jumping-off point, the experts on the panel seemed to agree that the model was not appropriate for the Flathead, because systems in place cover medical detox needs.

Kalispell police Chief Frank Garner said he saw a need for a smaller detox operation, perhaps operating as part of an existing mental-health facility to reduce the costs.

"Like everything else, there isn't anything that enough money won't fix," Garner said.

County Commissioner Joe Brenneman also was concerned about the cost, though he said there was "no doubt a need for a detox center." He added that the county has many needs the commission would like to fill.

"There isn't an unlimited supply of money," he said.

Brenneman reported that the county spent $256,000 in 2004-2005 for mental-health services. Most went to pay for services from providers such as Pathways and Warm Springs State Hospital.

Brenneman said he'd like to spend the dollars more wisely in preventative treatments.

Mike Cummins, director of the Flathead Valley Chemical Dependency Clinic, said that Rimrock Foundation - the detox component of the Billings center - spends $375,000 a year to keep six nonmedical beds available 24 hours a day.

"That gives us a target figure," he said.

Cummins characterized Rimrock's treatment as "enhanced, social detox."

Leslie Nyman of Kalispell Regional Medical Center said the hospital doesn't offer social detoxification. She also said that many of the people treated for medical risk at the hospital don't want to stay or receive treatment.

Nyman advised the panel to closely define the type of person who needs social detox and document the demand for grant-funding purposes.

"Without those numbers, you're dead in the water," Nyman said.

No one at the meeting had data on the need for social detox. Some statistics were provided about the problems of co-occurring mental-health and substance-abuse problems. Mary Jane Fox, a mental-health professional, said 80 percent of the admissions to the state hospital were for co-occurring disorders.

"The Number One cause of relapse [in mental illness] is drugs or alcohol use," Fox said.

Bartlett said that 59 percent of people in treatment for substance abuse have a history of mental illness. He said that the mental illness preceded the chemical abuse in 84 percent of those cases.

Jennifer Allen, a mental-health professional who is new to the Flathead, said she attended the meeting because she sees the need for a social detox center here. She said a Spokane center provides 15, 12-hour sobering-up beds and 15 more for a few days of voluntary treatment.

Allen, the No. 2 boss on a Spokane crisis team before moving here, found the facility extremely valuable in her intervention work.

"I really miss it," she said. "I'll do whatever it can to help the community develop one."

Others at the meeting proposed examining national statistics, as well as detox programs operating in areas similar to the Flathead, to better define the need. The group agreed to meet on a date and time in June to be announced later.

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