A federal investigation into mental health services in Alaska is a wake-up call. We are already working on improving the situation.

I read with interest Michelle Theriault Potts’ Dec. 16 article “Justice Department Investigation Finds Alaska Needlessly Institutionalizes Children, Violating Federal Law.” The story and report raise important issues, and it is my hope that the DOJ investigation will ultimately improve the mental health care system to better serve Alaskan children and families. It will take the combined efforts of the state, communities and service providers to get there.

The enormity of the problem may seem overwhelming. But I’m happy to report that progress is being made. The Medicaid Section 1115 exemption added new services and options to Alaska’s continuum of care, including services such as intensive outpatient and partial hospitalization programs designed to provide a high level of care while keeping children with their families. While it is not possible to offer a partial hospitalization program in person in every community in Alaska, it is a short-term program lasting two to three weeks that some families are able to transition during treatment and follow-up via telehealth. Alaska Behavioral Health and Volunteers of America offer PHP programs for children and teens in the Anchorage area.

Providing adequate services in rural communities will always be a challenge. Alaska Behavioral Health recently received federal funding to start a Rural Children’s Trauma Center. Through this grant, Alaska Behavioral Health will provide trauma training to rural community members, teaching them to identify signs of trauma, respond appropriately, and effectively connect children to follow-up care—whether that be via telehealth, an intensive short-term program, or a local provider. Training of service providers is also part of the grant.

Other efforts have focused more on wellness and building resilience. Stacy Rasmus and the University of Alaska Fairbanks Center for Local Health Research (CAHNR) have done tremendous work helping communities develop wellness programs for their youth and researching what works. More funding is needed to keep these programs going and reaching more communities.

Appropriate staffing is a major concern for both inpatient and outpatient care, as recent reports have highlighted. The $1.5 million grant from the University of Alaska Anchorage School of Social Work, announced in early December, is a step in the right direction to address this workforce challenge. Plans are being developed to bring a psychiatry residency program to Alaska as a way to recruit more physicians to the state.

There is no doubt about the political and organizational changes that need to be examined. How, why, and how much does Medicaid in Alaska pay for inpatient care versus outpatient care? Are there really no other options for young people with mental health needs, and if so, how do we find or create other options? How can we increase access to mental health care in schools? How can we best support struggling families? I and my colleagues in the Senate majority are aware of these needed improvements. Together with the Chairman of the Senate Health Committee, Senator David Wilson, we will focus on solutions.

This Department of Justice report is an alert (or perhaps more than a nudge) that our state, legislators, service providers, and our communities need to build on the momentum just begun with Waiver 1115 and make the bigger changes we need to safely and effectively serve our children, in their communities, and with their families. .

Alaska Senator-elect Kathy GesselAnd MS, APRN, AANP Fellow, She served in the Alaska Senate for 10 years and now represents Senate District E. She serves on the Board of Directors for Alaska Behavioral Health.

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