Legislators brainstorm how to fill gaps in South Dakota's behavioral health services

PIERRE, S.D. — State lawmakers discussed how to approach the process of ensuring a way to provide more immediate, local access to mental health services in South Dakota, a problem that hit close to home for Rep. Kevin Jensen.

Jensen, who serves as chairman for the legislature’s mental health interim committee, recalled how difficult it is for South Dakotans struggling with mental health issues to find providers in unexpected situations.

“My oldest son farms and he’s about nine miles from the interstate, and one evening, probably in early June, they noticed a young lady standing at the end of their driveway with no purse, no identification, her feet were bloody, and she said she had gotten off at the truck stop and left the vehicle because she was afraid,” Jensen recalled during a meeting in Pierre Tuesday, Aug. 4.

“She had walked that whole distance to their house with no shoes on, and my wife is an addiction counselor so they called her because they didn’t know what to do. The lady seemed a little incoherent as well, she seemed like she may be high on methamphetamine. And it’s a little hard to tell when someone’s on meth or if there’s some cognitive impairment.”

Jensen said the most frustrating part of the situation was the fact that his wife spent hours on the phone trying to find help for the woman.

“Basically she called providers and they said you’ll have to call us tomorrow morning to set up an appointment. So what do you do at 7 p.m. when you have someone in your house whose feet are bleeding and more than likely tweaking? Anyway, our son and daughter ended up taking her to her sister’s house 40 miles away,” Jensen said.

Later the next day, Jensen said his family learned that the woman was taken into police custody after the woman’s sister called authorities to take care of the situation.

“It isn’t just what do we do after, it’s often what do we do during a time of crisis to get somebody into placement? Again, this is a very wide subject we’re trying to deal with,” Jensen said.

The group of lawmakers discussed what to prioritize and a plan of attack to improve the state’s mental health systems, citing past interim committee meetings from previous years that yielded data showing a need for more localized mental health resources rather than creating a statewide system.

“Small deeds done are greater than great deeds planned,” Jensen said.

The committee discussed the need to figure out a way to remove the burden on the Human Services Center in Yankton, noting how patients from Rapid City have no other option but to be transported to the facility on the other side of the state and often have to wait for beds to open up before doing so.

Sen. Deb Soholt provided background information on last year’s findings and ways this year’s committee should move forward to make progress. The state should continue to strengthen a regional mental health services system so the care is provided on a local level.

Soholt added that money should not be at the forefront of legislators’ minds when trying to ensure there are quality mental health providers available to everyone in the state on a local level.

“We need to leverage talent, we need to leverage talent virtually, we need to have it regional,” Soholt said. “We need to course interrupt things to have it be the highest payment of care or have people go to jail. We have to stay laser focused on prevention, early intervention, crisis support on a regional basis.”

Rep. Carl Perry said he appreciated Soholt’s direction and advice, but didn’t want the committee to sideline the importance of finding funding during the process.

“I think we might have an opportunity, and that is the COVID relief fund. And if we can take any of these mental health issues and tie them into COVID response, we may be able to do things that we’ve never been able to do before,” Perry said. “And I think we need to open our eyes too, even though we need to put the person first, it’s really nice to think about putting the person first and have some money to pay for it.”

Soholt said that during Gov. Kristi Noem’s last call with legislators last week, Noem said her office is trying to extend the deadline on when CARES Act funds needs to be spent “so there’s not a panic of having to spend all that COVID Cares money by the end of 2020.”

“Hopefully there will be some extension so further policy development can happen during the 2021 legislative session in relation to spending that money in the best way possible. But the best way to do that is for your group to decide what there is to be done,” Soholt added.

Sen. Jean Hunoff reiterated the fact that CARES Act funds are one time funds and the state will need to find ways to sustain funding for any future programs or initiatives.

“Anything we put out for this vision, we have to look for sustainability. That’s the whole key around this,” Hunoff said.

Jensen added that the funding streams will become an issue regardless.

“And that’s where we’re going to have to rely on (the Department of Social Services) for a lot of help on what we can do with the dollars we have and where we can find dollars or reallocate dollars from other areas,” he said.

Rep. Tim Reed said last year’s committee was able to focus on housing and found that short term and traditional housing are both important to recovery.

Those struggling with mental health or addiction issues that do receive help still need community resources for when they come back to living life in their community so they don’t jeopardize their recovery.

“If you don’t have a place to go, you end up on a couch in some place where maybe you shouldn’t be and fall back into some of those bad habits,” Reed said.

“It’s very important for communities to develop this themselves. One of the main things we came up with was the idea of using peer support services.”

Reed said the idea of peer support services is having someone that’s gone through the same type of mental health issue or addiction to help someone that’s on the road to recovery.

“The whole idea was that if we could get to a regional system, there would be community support right away,” Reed said.

The interim committee will continue to meet in the future prior to the 2021 legislative session to expound on filling the gaps in the state’s behavioral health service system.