By Mike Jacobs
The Legislature has made significant progress on an issue many haven’t thought about, advocates agree.
The word “success” is used. So is “break through.”
But there’s more work ahead.
“It’s too early to celebrate,” Gov. Doug Burgum said. He’s made behavioral health a focus of his first months in office.
Behavioral health includes addictions, such as alcoholism and drug abuse, and behaviors that might grow out of them, including domestic abuse, or behaviors that might arise to support them, such as robbery to secure funds to maintain an addiction.
Often, behavioral health issues lead to incarceration.
And that’s expensive.
It costs North Dakota at least $40,000 a year to maintain an inmate in the state penitentiary, Burgum estimated.
“We can’t arrest ourselves to a solution,” he said. It’s the same phrase he used to describe his approach to settling the Dakota Access Pipeline protest earlier this year.
These high costs led North Dakota to adopt something called the “Justice Reinvestment Project,” which seeks to direct funding to counseling and other services rather than to jail time.
This breakthrough is “a big success” of a four-yearslong program to reform behavioral health programs, said Judy Lee of West Fargo, N.D., a Republican who chairs the Senate Human Services Committee.
Another success, said Rep Kathy Hogan, of Fargo, is the use of the term “behavioral health” rather than “mental illness.” Mental illness includes a stigma, she explained, behavioral health perhaps not so much. Hogan, a Democrat, chaired an interim committee that studied behavioral health issues in the state.
Lee cited a third success, standardizing certification for professionals dealing with behavioral health issues. These include social workers and counselors among others. Hogan also noted legislation that simplified licensing procedures and broadened the scope of practice for addiction counselors.
Equally important, Pam Sagness at the Department of Human Services said, is training first responders to identify and respond to behavioral health issues. This includes administering antidotes to drug overdoses. Sagness is the department’s director of behavior health.
Still another success is “tele-counseling,” in which professionals consult with clients remotely rather than face to face. “It’s surprisingly effective,” Sen. Lee said.
These training and policy advances have been overshadowed by money problems. Like other state agencies, the Department of Human Services is facing budget cuts, and some worthwhile programs have been curtailed, Sagness said.
Hogan warned that the Human Services Department budget pending in the Legislature “results in a reduction in clinical services.” That could mean “individuals will need services at already overburdened private systems or end up in jail.”
Sagness and others in the Human Services Department praised Burgum’s efforts and those of first lady Kathryn Helgaas Burgum. She visited Grand Forks and Fargo last week meeting with professionals and raising awareness of behavioral health issues.
Gov. Burgum said the interim between legislative sessions will be critical in developing policy for behavior health. “We need to look at this as a whole. We can’t continue budgeting in silos. We need to identify synergies and find savings in our day-to-day management.”
Reaching for a business metaphor, he said his goal is to “move costs upstream,” toward early intervention and treatment and away from incarceration.
Stigma remains a barrier to progress, the governor said, and overcoming the stigma is a step forward. “When we have a moment that society is changing its views, then we have a moment when re-invention is possible,” Burgum said.