Article: State struggles to keep up with demand for mental health care

[Phil in Paris]

Tuesday December 21, 2004

WATERTOWN (AP) - A lack of funding and the state's geographic size are among obstacles South Dakota faces in providing adequate mental health services, according to professionals and families who live with mental illness.

Census data in 2000 show 19,229 adults in the state suffered from serious and persistent mental illness. Additionally, 15,453 children had serious emotional disturbances - about one out of every 12 children in the state.

"The stigma of mental illness, for one, results in people not seeking services early or at all, even though effective treatments are available," Betty Oldenkamp, secretary of the South Dakota Human Services Department, said. "And the geography of the state, especially in frontier areas, frequently makes service delivery via traditional means difficult."

In South Dakota, 54 of the 66 counties are designated as federal mental health professional shortage areas. The ranking comes because there only are 71 psychiatrists registered with the state Medical Association, including eight who work solely with children and one who works with both adults and children.

Of those professionals, almost two-thirds work in Sioux Falls or Rapid City.

Jim Kinyon, director of Catholic Social Services in Rapid City, said the figure shows there are widespread gaps in mental health care coverage in South Dakota.

"If you live in McLaughlin, and your daughter has been raped, who is available on any kind of ongoing basis to help them with that?" Kinyon asked. "If your son goes to school at Martin and has attention deficit (disorder) and is failing school, who is going to work with the family and school system to provide supports and information to help that son succeed?"

Oldenkamp said state officials have made gains despite tight budget constraints.

In fiscal year 2003, the state spent $20.2 million on its community mental health centers and their related programs, and another $32 million on the Human Services Center in Yankton. On top of that, Medicaid paid out $12 million in services provided by private practitioners.

Terry Dosch, executive director of the South Dakota Council of Mental Health Center, knows of the challenges. But changes have been made, too, he said.

"Clearly, there are people who have difficulty obtaining services because there is no money to pay for it ... for a variety of reasons," said Dosch, whose council represents the state's 11 regional mental health centers.

"But I am pleased to say that, from the publicly supported standpoint, we are serving more South Dakotans each year, and our budget continues to grow in modest increments versus the budget paring that many states are experiencing right now."

When communities don't have services to deal with mental illnesses, some with mental health problems end up in detention, foster care or residential treatment away from their families and homes, Kinyon said.

"What it comes down to is, when a family is not functioning well enough to meet the needs of these kids, and the community has no resources to meet their needs, you end up institutionalizing those kids in judicial or mental health systems," Kinyon said.

Of the little more than 1,000 youths now in the state corrections system, about 7 percent have significant mental health issues that require them to be placed in long-term residential care, according to Doug Herrmann, head of the juvenile division of the state Department of Corrections.

Patty Anderson of Watertown, whose 22-year-old son, Michael, died of suicide almost three years ago, said the mental health care system failed her son and his family.

Michael was 14 when he was diagnosed with borderline paranoid schizophrenia. He was treated at the Human Services Agency in Watertown and spent time at the Human Services Center in Yankton.

But often the quest for help became more of a battle, Patty Anderson said.

"We had to fight for his education," she said. "We had to fight the Department of Corrections. We had to fight the courts. And nothing we ever did helped. We always heard, 'He has to be accountable.' And when we tried to tell them about his mental illness, people treated us like he was just faking it."

Eventually, her son's actions landed him in prison.

Then on March 7, 2002, while in a segregation unit, he strung his bedsheet through a hole in a steel plate in the wall and hanged himself. He died on March 13 at Sioux Valley Hospital.

His death makes no sense, Patty Anderson said.

"The system let him down every step of the way."

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